Sample records for hammer syndrome case

  1. Break-dance: an unusual cause of hammer syndrome.

    PubMed

    Schneider, Frédéric; Milesi, Ilaria; Haesler, Erik; Wicky, Stephan; Schnyder, P; Denys, Alban

    2002-01-01

    We report the case of a young break-dancer presenting with hammer syndrome. This syndrome has been correlated with many professional and recreational activities but this is, to our knowledge, the first description of hammer syndrome caused by break-dancing. The etiology, diagnosis and treatment modalities of this rare syndrome are considered.

  2. Break-Dance: An Unusual Cause of Hammer Syndrome

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Schneider, Frederic; Milesi, Ilaria; Haesler, Erik

    2002-08-15

    We report the case of a young break-dancer presenting with hammer syndrome. This syndrome has been correlated with many professional and recreational activities but this is, to our knowledge, the first description of hammer syndrome caused by break-dancing. The etiology, diagnosis and treatment modalities of this rare syndrome are considered.

  3. Hypothenar hammer syndrome and basilic bypass.

    PubMed

    Chander, R K; Phair, J; Oza, P; Patel, M; Balar, N

    2014-12-01

    We report a case of hypothenar hammer syndrome. The case presents necessary diagnostic measures and discusses the etiology of this syndrome. Additionally, the case reviews treatments, which culminated in the eventual use of ulnar artery bypass with autogenous basilica vein to treat and resolve the ischemic fingers of the patient. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  4. Hypothenar hammer syndrome: a case and brief review.

    PubMed

    Swanson, Keith E; Bartholomew, John R; Paulson, Rolf

    2012-04-01

    Hypothenar hammer syndrome is an uncommon cause of upper-extremity ischemia that is often overlooked in the absence of a thorough occupational and recreational history. Importantly, it is a reversible cause of hand ischemia that, if missed, can lead to significant morbidity and even amputation. The occupational ramifications and quality of life of those affected can be significant. Its relative rarity, set against the ubiquitous use of the hand as a 'hammer' is noteworthy. Several other causes of hand ischemia can present similarly; therefore, consideration of other etiologies must be thoroughly investigated. Key distinguishing clinical features, in addition to a detailed occupational and recreational history, may include characteristic sparing of the thumb, the absence of a hyperemic phase in 'Raynaud's phenomenon', and a positive Allen's sign. Both non-invasive and invasive diagnostic studies, including bilateral upper-limb segmental pulse volume recordings (PVR), arterial duplex examination, and upper-extremity angiography, are complementary to a thorough history and physical examination. Optimal management strategies are not well defined because of its rarity and resultant lack of quality, evidence-based data. Though most cases can be successfully managed non-operatively, micrographic arterial reconstruction may be limb saving in severe or recalcitrant cases. Newer, experimental strategies including selective sympathetic blockage using botulinum toxin A have been reported in a few recalcitrant cases. The brief case description illustrates the typical presentation and potential treatment strategies employed in a difficult case. A review of relevant literature is also presented.

  5. Ulnar hammer syndrome: a systematic review of the literature.

    PubMed

    Vartija, Larisa; Cheung, Kevin; Kaur, Manraj; Coroneos, Christopher James; Thoma, Achilleas

    2013-11-01

    Ulnar hammer syndrome is an uncommon form of arterial insufficiency. Many treatments have been described, and debate continues about the best option. The goal of this systematic review was to determine whether ulnar hammer syndrome has an occupational association, to identify the most reliable diagnostic test, and to determine the best treatment modality. A comprehensive literature search was conducted using the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, and EMBASE. Data from articles meeting inclusion criteria were collected in duplicate. Methodological quality of studies was assessed using the Methodological Index for Nonrandomized Studies scale. Thirty studies were included in the systematic review. No randomized controlled trials were identified. There is low-quality evidence suggestive of an association between exposure to repetitive hand trauma and vibration and ulnar hammer syndrome. Various diagnostic investigations were used, but few were compared, making it difficult to determine the most reliable diagnostic test. Numerous nonoperative and operative treatments were reported. With nonoperative treatment, 12 percent had complete resolution and 70 percent had partial resolution of their symptoms. Of patients treated operatively, 42.5 percent had complete resolution and 42.5 percent had partial resolution of their symptoms. The heterogeneity in study design and outcome measures limits definitive conclusions about occupational association, best diagnostic test, and treatment for ulnar hammer syndrome. However, there is low-quality evidence that suggests that most patients with ulnar hammer syndrome will have partial relief of symptoms with nonoperative treatment, and operative treatment results in complete or partial resolution of symptoms in the majority of cases. Therapeutic, IV.

  6. Hypothenar hammer syndrome in sports.

    PubMed

    Müller, L P; Rudig, L; Kreitner, K F; Degreif, J

    1996-01-01

    Repetitive blunt trauma or single severe trauma to the hypothenar region may lead to traumatic thrombosis of the distal ulnar artery (hypothenar hammer syndrome, HHS). In the sports-related literature we found and analysed isolated cases attributed to injuries sustained during sporting activities such as baseball, badminton, handball, football, frisbee, softball, karate, weight-lifting and hockey. Further, we report the case of an amateur golf player with ischaemic symptoms of his left hand, where angiography revealed filling defects in the digital arteries associated with a corkscrew-like configuration of the distal ulnar artery. Magnetic resonance imaging (MRI) scan demonstrated, at the level of the hamulus ossis hamati, accessory fibres of m. palmaris brevis forming a sling around the ulnar artery. Treatment by resection of the thrombosed a. ulnaris segment and replacement with an autologous vein graft resulted in complete relief of symptoms. Histological sections revealed partially organized thrombi adherent to the intimal surface with fragmentation of the internal elastic membrane, indicating a traumatic genesis. As the mechanism of injury, we suspected intensive golf playing with the grip style and subsequent motions leading to pressure injury of the hypothenar area and the underlying ulnar artery. Contraction of the anomalous muscle belly may have additionally compressed the artery, slowing down the arterial flow and promoting thrombosis. In most reported cases including our own, it took a relatively long time until the cause of the disease as traumatic was found and accepted. The initial repetitive blunt or single severe trauma initiating the HHS can easily be overlooked or ignored. After intimal damage of a. ulnaris, the beginning of symptoms may be prolonged and mislead one into thinking the cause is a collagen or vasospastic disease.

  7. Hypothenar hammer syndrome from ice hockey stick-handling.

    PubMed

    Zayed, Mohamed A; McDonald, Joey; Tittley, Jacques G

    2013-11-01

    Ulnar artery thrombosis and hypothenar hammer syndrome are rare vascular complications that could potentially occur with repeated blows or trauma to the hand. Although initially reported as an occupational hazard among laborers and craftsmen, it has been observed more recently among recreationalists and athletes. Until now, it has never been reported as a complication in ice hockey players. In this case report, a 26-year-old Canadian professional ice hockey player presented with acute dominant right hand paleness, coolness, and pain with hand use. The patient used a wooden hockey stick with a large knob of tape at the end of the handle, which he regularly gripped in the palm of his right hand to help with face-offs and general stick-handling. Sonographic evaluation demonstrated no arterial flow in the distal right ulnar artery distribution, and ulnar artery occlusion with no aneurysmal degeneration was confirmed by magnetic resonance angiogram. Intraarterial thrombolytic therapy was initiated, and subsequent serial angiograms demonstrated significant improvement in distal ulnar artery flow as well as recanalization of right hand deep palmar arch and digital arteries. The patient's symptoms resolved, and he was maintained on therapeutic anticoagulation for 3 months prior to returning to playing ice hockey professionally, but with a padded glove and no tape knob at the handle tip. This case highlights a unique presentation of hockey stick-handling causing ulnar artery thrombosis that was likely from repeated palmar hypothenar trauma. Appropriate diagnostic imaging, early intraarterial thrombolysis, and postoperative surveillance and follow-up were crucial for the successful outcome in this patient. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Hammered Strings

    NASA Astrophysics Data System (ADS)

    Rossing, Thomas D.

    In the next three chapters we consider the science of hammered string instruments. In this chapter, we present a brief discussion of vibrating strings excited by a hard or soft hammer. Chapter 20 discusses the most important hammered string instrument, the piano - probably the most versatile and popular of all musical instruments. Chapter 21 discusses hammered dulcimers, especially the American folk dulcimer.

  9. WATER HAMMER OSCILLATIONS IN THE IRRIGATION FACILITIES

    NASA Astrophysics Data System (ADS)

    Kurata, Kouichi; Sasaki, Katsuhito; Makihata, Toshiaki

    In case a gate installed at the end of discharge conduit is vibrating during discharge, or an air valve is vibrating during water-filling operation into the conduit pipe between main gate and auxiliary gate, and vibration period tv is larger than tc (water hammer propagation time) that is equivalent to the phenomenon of slow closure, there is a possibility that water hammer oscillation in the discharge conduit could be induced. In this paper, by using two case examples, vibration phenomena transmitted to each part are analyzed, on the basis of water pressure fluctuation and pressure wave propagation due to occurrence of water hammer oscillation.

  10. Simulation of low pressure water hammer

    NASA Astrophysics Data System (ADS)

    Himr, D.; Habán, V.

    2010-08-01

    Numerical solution of water hammer is presented in this paper. The contribution is focused on water hammer in the area of low pressure, which is completely different than high pressure case. Little volume of air and influence of the pipe are assumed in water, which cause sound speed change due to pressure alterations. Computation is compared with experimental measurement.

  11. Ultrasonic rotary-hammer drill

    NASA Technical Reports Server (NTRS)

    Bar-Cohen, Yoseph (Inventor); Badescu, Mircea (Inventor); Sherrit, Stewart (Inventor); Kassab, Steve (Inventor); Bao, Xiaoqi (Inventor)

    2010-01-01

    A mechanism for drilling or coring by a combination of sonic hammering and rotation. The drill includes a hammering section with a set of preload weights mounted atop a hammering actuator and an axial passage through the hammering section. In addition, a rotary section includes a motor coupled to a drive shaft that traverses the axial passage through the hammering section. A drill bit is coupled to the drive shaft for drilling by a combination of sonic hammering and rotation. The drill bit includes a fluted shaft leading to a distal crown cutter with teeth. The bit penetrates sampled media by repeated hammering action. In addition, the bit is rotated. As it rotates the fluted bit carries powdered cuttings helically upward along the side of the bit to the surface.

  12. Hammered Dulcimer

    NASA Astrophysics Data System (ADS)

    Peterson, David

    The hammered dulcimer, a direct ancestor of the clavichord and the pianoforte, is a folk instrument that developed from eleventh-century antecedents such as the psaltery. They are trapezoidal in shape, with a long base of 40-45 in. and height of 15-18 in. Two bridges, treble and bass, each support 11-16 courses of strings, which are struck with light wooden hammers. The treble bridge divides the strings into a musical fifth, which facilitates the fast playing of diatonic melodies. Historically, the instrument was used as a rhythmic back-up for fiddles and other lead instruments, but since being popularized in the 1970s folk revival, it has become a solo or lead instrument in ensembles. The hammered dulcimer shares many acoustic properties with the piano except that the dulcimer is smaller and undamped, and the lighter, harder hammers give a more percussive sound. A hammered dulcimer player can also play double strokes and can alter instrument timbre by changing strike location. Current instruments are lightweight, 13-30 lb, and reasonably stable, but temperature and humidity changes cause tuning problems which are related to the linear scaling that is intrinsic to the trapezoidal design.

  13. Pump-stopping water hammer simulation based on RELAP5

    NASA Astrophysics Data System (ADS)

    Yi, W. S.; Jiang, J.; Li, D. D.; Lan, G.; Zhao, Z.

    2013-12-01

    RELAP5 was originally designed to analyze complex thermal-hydraulic interactions that occur during either postulated large or small loss-of-coolant accidents in PWRs. However, as development continued, the code was expanded to include many of the transient scenarios that might occur in thermal-hydraulic systems. The fast deceleration of the liquid results in high pressure surges, thus the kinetic energy is transformed into the potential energy, which leads to the temporary pressure increase. This phenomenon is called water hammer. Generally water hammer can occur in any thermal-hydraulic systems and it is extremely dangerous for the system when the pressure surges become considerably high. If this happens and when the pressure exceeds the critical pressure that the pipe or the fittings along the pipeline can burden, it will result in the failure of the whole pipeline integrity. The purpose of this article is to introduce the RELAP5 to the simulation and analysis of water hammer situations. Based on the knowledge of the RELAP5 code manuals and some relative documents, the authors utilize RELAP5 to set up an example of water-supply system via an impeller pump to simulate the phenomena of the pump-stopping water hammer. By the simulation of the sample case and the subsequent analysis of the results that the code has provided, we can have a better understand of the knowledge of water hammer as well as the quality of the RELAP5 code when it's used in the water-hammer fields. In the meantime, By comparing the results of the RELAP5 based model with that of other fluid-transient analysis software say, PIPENET. The authors make some conclusions about the peculiarity of RELAP5 when transplanted into water-hammer research and offer several modelling tips when use the code to simulate a water-hammer related case.

  14. Treatise on water hammer in hydropower standards and guidelines

    NASA Astrophysics Data System (ADS)

    Bergant, A.; Karney, B.; Pejović, S.; Mazij, J.

    2014-03-01

    This paper reviews critical water hammer parameters as they are presented in official hydropower standards and guidelines. A particular emphasize is given to a number of IEC standards and guidelines that are used worldwide. The paper critically assesses water hammer control strategies including operational scenarios (closing and opening laws), surge control devices (surge tank, pressure regulating valve, flywheel, etc.), redesign of the water conveyance system components (tunnel, penstock), or limitation of operating conditions (limited operating range) that are variably covered in standards and guidelines. Little information is given on industrial water hammer models and solutions elsewhere. These are briefly introduced and discussed in the light of capability (simple versus complex systems), availability of expertise (in house and/or commercial) and uncertainty. The paper concludes with an interesting water hammer case study referencing the rules and recommendations from existing hydropower standards and guidelines in a view of effective water hammer control. Recommendations are given for further work on development of a special guideline on water hammer (hydraulic transients) in hydropower plants.

  15. Hypothenar Hammer Syndrome Caused by Recreational Sports Activities and Muscle Anomaly in the Wrist

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kreitner, Karl-Friedrich; Dueber, Christoph; Mueller, Lars-Peter

    1996-09-15

    A 34-year-old man with digital ischemia is reported. Angiography revealed thromboembolic occlusions of the proper digital arteries of the index, middle, and ring fingers and a tortuous ulnar artery in Guyon's canal. Though hypothenar hammer syndrome was suspected, there was no relevant occupational history. Magnetic resonance imaging and magnetic resonance angiography demonstrated an anomalous muscular sling around the ulnar artery immediately adjacent to the hook of the hamate. The ulnar artery showed mural thrombi in its tortuous segment. These findings were confirmed during operative exploration. After thrombectomy and embolectomy the involved segment of the ulnar artery was replaced by anmore » autologous vein graft. Postoperatively there was complete resolution of the symptoms. Only during convalescence did it become clear that the patient was a passionate golfer.« less

  16. Optimization of Mud Hammer Drilling Performance--A Program to Benchmark the Viability of Advanced Mud Hammer Drilling

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Arnis Judzis

    2006-03-01

    Operators continue to look for ways to improve hard rock drilling performance through emerging technologies. A consortium of Department of Energy, operator and industry participants put together an effort to test and optimize mud driven fluid hammers as one emerging technology that has shown promise to increase penetration rates in hard rock. The thrust of this program has been to test and record the performance of fluid hammers in full scale test conditions including, hard formations at simulated depth, high density/high solids drilling muds, and realistic fluid power levels. This paper details the testing and results of testing two 7more » 3/4 inch diameter mud hammers with 8 1/2 inch hammer bits. A Novatek MHN5 and an SDS Digger FH185 mud hammer were tested with several bit types, with performance being compared to a conventional (IADC Code 537) tricone bit. These tools functionally operated in all of the simulated downhole environments. The performance was in the range of the baseline ticone or better at lower borehole pressures, but at higher borehole pressures the performance was in the lower range or below that of the baseline tricone bit. A new drilling mode was observed, while operating the MHN5 mud hammer. This mode was noticed as the weight on bit (WOB) was in transition from low to high applied load. During this new ''transition drilling mode'', performance was substantially improved and in some cases outperformed the tricone bit. Improvements were noted for the SDS tool while drilling with a more aggressive bit design. Future work includes the optimization of these or the next generation tools for operating in higher density and higher borehole pressure conditions and improving bit design and technology based on the knowledge gained from this test program.« less

  17. TPS-HAMMER: improving HAMMER registration algorithm by soft correspondence matching and thin-plate splines based deformation interpolation.

    PubMed

    Wu, Guorong; Yap, Pew-Thian; Kim, Minjeong; Shen, Dinggang

    2010-02-01

    We present an improved MR brain image registration algorithm, called TPS-HAMMER, which is based on the concepts of attribute vectors and hierarchical landmark selection scheme proposed in the highly successful HAMMER registration algorithm. We demonstrate that TPS-HAMMER algorithm yields better registration accuracy, robustness, and speed over HAMMER owing to (1) the employment of soft correspondence matching and (2) the utilization of thin-plate splines (TPS) for sparse-to-dense deformation field generation. These two aspects can be integrated into a unified framework to refine the registration iteratively by alternating between soft correspondence matching and dense deformation field estimation. Compared with HAMMER, TPS-HAMMER affords several advantages: (1) unlike the Gaussian propagation mechanism employed in HAMMER, which can be slow and often leaves unreached blotches in the deformation field, the deformation interpolation in the non-landmark points can be obtained immediately with TPS in our algorithm; (2) the smoothness of deformation field is preserved due to the nice properties of TPS; (3) possible misalignments can be alleviated by allowing the matching of the landmarks with a number of possible candidate points and enforcing more exact matches in the final stages of the registration. Extensive experiments have been conducted, using the original HAMMER as a comparison baseline, to validate the merits of TPS-HAMMER. The results show that TPS-HAMMER yields significant improvement in both accuracy and speed, indicating high applicability for the clinical scenario. Copyright (c) 2009 Elsevier Inc. All rights reserved.

  18. Dynamic Analysis of Hammer Mechanism "Twin Hammer" of Impact Wrench

    NASA Astrophysics Data System (ADS)

    Konečný, M.; Slavík, J.

    This paper describes function of the hammer mechanism "Twin hammer" the impact wrench, calculation of dynamic forces exerted on the mechanism and determining the contact pressures between the parts of the mechanism. The modelling of parts was performed in system Pro ENGINEER—standard. The simulation and finding dynamic forces was performed in advanced module Pro ENGINEER—mechanism design and finding contacts pressures in modul Pro ENGENEER—mechanica.

  19. OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE - A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Arnis Judzis

    2003-01-01

    This document details the progress to date on the ''OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE -- A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING'' contract for the quarter starting October 2002 through December 2002. Even though we are awaiting the optimization portion of the testing program, accomplishments included the following: (1) Smith International participated in the DOE Mud Hammer program through full scale benchmarking testing during the week of 4 November 2003. (2) TerraTek acknowledges Smith International, BP America, PDVSA, and ConocoPhillips for cost-sharing the Smith benchmarking tests allowing extension of the contract to add to themore » benchmarking testing program. (3) Following the benchmark testing of the Smith International hammer, representatives from DOE/NETL, TerraTek, Smith International and PDVSA met at TerraTek in Salt Lake City to review observations, performance and views on the optimization step for 2003. (4) The December 2002 issue of Journal of Petroleum Technology (Society of Petroleum Engineers) highlighted the DOE fluid hammer testing program and reviewed last years paper on the benchmark performance of the SDS Digger and Novatek hammers. (5) TerraTek's Sid Green presented a technical review for DOE/NETL personnel in Morgantown on ''Impact Rock Breakage'' and its importance on improving fluid hammer performance. Much discussion has taken place on the issues surrounding mud hammer performance at depth conditions.« less

  20. Prediction of distance in hammer throwing.

    PubMed

    Dapena, Jesús; Gutiérrez-Dávila, Marcos; Soto, Víctor M; Rojas, Francisco J

    2003-01-01

    The aim of this study was to determine how much the predicted distance of a hammer throw is affected by (1) ignoring air resistance and (2) assuming that the centre of mass of the hammer coincides with the centre of the ball. Three-dimensional data from actual throws (men: 72.82 +/- 7.43 m; women: 67.78 +/- 4.02 m) were used to calculate the kinematic conditions of the hammer at release. A mathematical model of the hammer was then used to simulate the three-dimensional airborne motion of the hammer and to predict the distance of the throw. The distance predicted for vacuum conditions and using the ball centre to represent the hammer centre of mass was 4.30 +/- 2.64 m longer than the official distance of the throw for the men and 8.82 +/- 3.20 m longer for the women. Predictions using the true centre of mass of the hammer reduced the discrepancy to 2.39 +/- 2.58 m for the men and 5.28 +/- 2.88 m for the women. Predictions using air resistance and the true centre of mass of the hammer further reduced the discrepancy to -0.46 +/- 2.63 m for the men and 1.16 +/- 2.31 m for the women. Approximately half the loss of distance produced by air resistance was due to forces made on the ball and the remainder to forces made on the cable and handle. Equations were derived for calculation of the effects of air resistance and of the assumption that the centre of mass of the hammer coincides with the centre of the ball, on the distance of the throw.

  1. Vascular hand-arm vibration syndrome--magnetic resonance angiography.

    PubMed

    Poole, C J M; Cleveland, T J

    2016-01-01

    The diagnosis of vascular hand-arm vibration syndrome (HAVS) requires consistent symptoms, photographic evidence of digital blanching and sufficient exposure to hand-transmitted vibration (HTV; A(8) > 2.5 m/s2). There is no reliable quantitative investigation for distinguishing HAVS from other causes of Raynaud's phenomenon and from normal individuals. Hypothenar and thenar hammer syndromes produce similar symptoms to HAVS but are difficult to diagnose clinically and may be confused with HAVS. Magnetic resonance angiography (MRA) is a safe and minimally invasive method of visualizing blood vessels. Three cases of vascular HAVS are described in which MRA revealed occlusions of the ulnar, radial and superficial palmar arteries. It is proposed that HTV was the cause of these occlusions, rather than blows to the hand unrelated to vibration, the assumed mechanism for the hammer syndromes. All three cases were advised not to expose their hands to HTV despite one of them being at Stockholm vascular stage 2 (early). MRA should be the investigation of choice for stage 2 vascular HAVS or vascular HAVS with unusual features or for a suspected hammer syndrome. The technique is however technically challenging and best done in specialist centres in collaboration with an occupational physician familiar with the examination of HAVS cases. Staging for HAVS should be developed to include anatomical arterial abnormalities as well as symptoms and signs of blanching. Workers with only one artery supplying a hand, or with only one palmar arch, may be at increased risk of progression and therefore should not be exposed to HTV irrespective of their Stockholm stage. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE - A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Arnis Judzis

    2002-10-01

    This document details the progress to date on the OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE -- A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING contract for the quarter starting July 2002 through September 2002. Even though we are awaiting the optimization portion of the testing program, accomplishments include the following: (1) Smith International agreed to participate in the DOE Mud Hammer program. (2) Smith International chromed collars for upcoming benchmark tests at TerraTek, now scheduled for 4Q 2002. (3) ConocoPhillips had a field trial of the Smith fluid hammer offshore Vietnam. The hammer functioned properly, though themore » well encountered hole conditions and reaming problems. ConocoPhillips plan another field trial as a result. (4) DOE/NETL extended the contract for the fluid hammer program to allow Novatek to ''optimize'' their much delayed tool to 2003 and to allow Smith International to add ''benchmarking'' tests in light of SDS Digger Tools' current financial inability to participate. (5) ConocoPhillips joined the Industry Advisors for the mud hammer program. (6) TerraTek acknowledges Smith International, BP America, PDVSA, and ConocoPhillips for cost-sharing the Smith benchmarking tests allowing extension of the contract to complete the optimizations.« less

  3. OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE - A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Arnis Judzis

    2003-07-01

    This document details the progress to date on the ''OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE--A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING'' contract for the quarter starting April 2003 through June 2003. The DOE and TerraTek continue to wait for Novatek on the optimization portion of the testing program (they are completely rebuilding their fluid hammer). Accomplishments included the following: (1) Hughes Christensen has recently expressed interest in the possibility of a program to examine cutter impact testing, which would be useful in a better understanding of the physics of rock impact. Their interest however is notmore » necessarily fluid hammers, but to use the information for drilling bit development. (2) Novatek (cost sharing supplier of tools) has informed the DOE project manager that their tool may not be ready for ''optimization'' testing late summer 2003 (August-September timeframe) as originally anticipated. During 3Q Novatek plans to meet with TerraTek to discuss progress with their tool for 4Q 2003 testing. (3) A task for an addendum to the hammer project related to cutter impact studies was written during 2Q 2003. (4) Smith International internally is upgrading their hammer for the optimization testing phase. One currently known area of improvement is their development program to significantly increase the hammer blow energy.« less

  4. OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE--A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Arnis Judzis

    2004-04-01

    This document details the progress to date on the OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE--A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING contract for the quarter starting January 2004 through March 2004. The DOE and TerraTek continue to wait for Novatek on the optimization portion of the testing program (they are completely rebuilding their fluid hammer). The latest indication is that the Novatek tool would be ready for retesting only 3Q 2004. Smith International's hammer will be tested in April of 2004 (2Q 2004 report). Accomplishments included the following: (1) TerraTek presented a paper for publication inmore » conjunction with a peer review at the GTI Natural Gas Technologies Conference February 10, 2004. Manuscripts and associated presentation material were delivered on schedule. The paper was entitled ''Mud Hammer Performance Optimization''. (2) Shell Exploration and Production continued to express high interest in the ''cutter impact'' testing program Task 8. Hughes Christensen supplied inserts for this testing program. (3) TerraTek hosted an Industry/DOE planning meeting to finalize a testing program for ''Cutter Impact Testing--Understanding Rock Breakage with Bits'' on February 13, 2004. (4) Formal dialogue with Terralog was initiated. Terralog has recently been awarded a DOE contract to model hammer mechanics with TerraTek as a sub-contractor. (5) Novatek provided the DOE with a schedule to complete their new fluid hammer and test it at TerraTek.« less

  5. A Universal Rig for Supporting Large Hammer Drills: Reduced Injury Risk and Improved Productivity

    PubMed Central

    Rempel, David; Barr, Alan

    2015-01-01

    Drilling holes into concrete with heavy hammer and rock drills is one of the most physically demanding tasks performed in commercial construction and poses risks for musculoskeletal disorders, noise induced hearing loss, hand arm vibration syndrome and silicosis. The aim of this study was to (1) use a participatory process to develop a rig to support pneumatic rock drills or large electric hammer drills in order to reduce the health risks and (2) evaluate the usability of the rig. Seven prototype rigs for supporting large hammer drills were developed and modified with feedback from commercial contractors and construction workers. The final design was evaluated by laborers and electricians (N=29) who performed their usual concrete drilling with the usual method and the new rig. Subjective regional fatigue was significantly less in the neck, shoulders, hands and arms, and lower back) when using the universal rig compared to the usual manual method. Usability ratings for the rig were significantly better than the usual method on stability, control, drilling, accuracy, and vibration. Drilling time was reduced by approximately 50% with the rig. Commercial construction contractors, laborers and electricians who use large hammer drills for drilling many holes should consider using such a rig to prevent musculoskeletal disorders, fatigue, and silicosis. PMID:26005290

  6. OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE - A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Alan Black; Arnis Judzis

    2003-01-01

    Progress during current reporting year 2002 by quarter--Progress during Q1 2002: (1) In accordance to Task 7.0 (D. No.2 Technical Publications) TerraTek, NETL, and the Industry Contributors successfully presented a paper detailing Phase 1 testing results at the February 2002 IADC/SPE Drilling Conference, a prestigious venue for presenting DOE and private sector drilling technology advances. The full reference is as follows: IADC/SPE 74540 ''World's First Benchmarking of Drilling Mud Hammer Performance at Depth Conditions'' authored by Gordon A. Tibbitts, TerraTek; Roy C. Long, US Department of Energy, Brian E. Miller, BP America, Inc.; Arnis Judzis, TerraTek; and Alan D. Black,more » TerraTek. Gordon Tibbitts, TerraTek, will presented the well-attended paper in February of 2002. The full text of the Mud Hammer paper was included in the last quarterly report. (2) The Phase 2 project planning meeting (Task 6) was held at ExxonMobil's Houston Greenspoint offices on February 22, 2002. In attendance were representatives from TerraTek, DOE, BP, ExxonMobil, PDVSA, Novatek, and SDS Digger Tools. (3) PDVSA has joined the advisory board to this DOE mud hammer project. PDVSA's commitment of cash and in-kind contributions were reported during the last quarter. (4) Strong Industry support remains for the DOE project. Both Andergauge and Smith Tools have expressed an interest in participating in the ''optimization'' phase of the program. The potential for increased testing with additional Industry cash support was discussed at the planning meeting in February 2002. Progress during Q2 2002: (1) Presentation material was provided to the DOE/NETL project manager (Dr. John Rogers) for the DOE exhibit at the 2002 Offshore Technology Conference. (2) Two meeting at Smith International and one at Andergauge in Houston were held to investigate their interest in joining the Mud Hammer Performance study. (3) SDS Digger Tools (Task 3 Benchmarking participant) apparently has not negotiated

  7. Unique perceptuomotor control of stone hammers in wild monkeys.

    PubMed

    Mangalam, Madhur; Pacheco, Matheus Maia; Izar, Patrícia; Visalberghi, Elisabetta; Fragaszy, Dorothy Munkenbeck

    2018-01-01

    We analysed the patterns of coordination of striking movement and perceptuomotor control of stone hammers in wild bearded capuchin monkeys, Sapajus libidinosus as they cracked open palm nut using hammers of different mass, a habitual behaviour in our study population. We aimed to determine why these monkeys cannot produce conchoidally fractured flakes as do contemporary human knappers or as did prehistoric hominin knappers. We found that the monkeys altered their patterns of coordination of movement to accommodate changes in hammer mass. By altering their patterns of coordination, the monkeys kept the strike's amplitude and the hammer's velocity at impact constant with respect to hammer mass. In doing so, the hammer's kinetic energy at impact-which determines the propagation of a fracture/crack in a nut-varied across hammers of different mass. The monkeys did not control the hammer's kinetic energy at impact, the key parameter a perceiver-actor should control while knapping stones. These findings support the hypothesis that the perceptuomotor control of stone hammers in wild bearded capuchin monkeys is inadequate to produce conchoidally fractured flakes by knapping stones, as do humans. © 2018 The Author(s).

  8. Numerical and in-situ investigations of water hammer effects in Drava river Kaplan turbine hydropower plants

    NASA Astrophysics Data System (ADS)

    Bergant, A.; Gregorc, B.; Gale, J.

    2012-11-01

    This paper deals with critical flow regimes that may induce unacceptable water hammer in Kaplan turbine hydropower plants. Water hammer analysis should be performed for normal, emergency and catastrophic operating conditions. Hydropower plants with Kaplan turbines are usually comprised of relatively short inlet and outlet conduits. The rigid water hammer theory can be used for this case. For hydropower plants with long penstocks the elastic water hammer should be used. Some Kaplan turbine units are installed in systems with long open channels. In this case, water level oscillations in the channels should be carefully investigated. Computational results are compared with results of measurements in recently rehabilitated seven Drava river hydroelectric power plants in Slovenia. Water hammer in the six power plants is controlled by appropriate adjustment of the wicket gates and runner blades closing/opening manoeuvres. Due to very long inflow and outflow open channels in Zlatoličje HPP a special vaned pressure regulating device attenuates extreme pressures in Kaplan turbine flow-passage system and controls unsteady flow in both open channels. Comparisons of results include normal operating regimes. The agreement between computed and measured results is reasonable.

  9. Water hammer effect in the spiral case and penstock of Francis turbines

    NASA Astrophysics Data System (ADS)

    Pepa, D.; Ursoniu, C.; Gillich, R. N.; Campian, C. V.

    2017-01-01

    Sudden pressure increases in the penstock or spiral case of a hydraulic turbine are the effect of sudden flow variation that occur during transient processes of type opening / closing or load rejection of the hydro unit. The consequence of the pressure rise in the spiral case and penstock is the water hammer phenomenon, whose effects can be devastating in some cases, up to breaking pipes and calamities produced in the area. This paper aims to analyze the method of calculation of the maximum pressure values that might occur in load rejection situations to a hydraulic turbine, in spiral case and in penstock, conditioned by the limiting of the values of the over speed and measures of limiting the increase in pressure in conjunction with limiting the increase in speed in these specific processes. As an example, we studied and analyzed the situation of a hydroelectric power plant equipped with a 7.8 MW Francis turbine without pressure regulator and the inflow surge. The results of analytical calculation overlaid on the experimental measurements performed during the performance tests of the hydro unit lead to the conclusion that the calculation algorithm proposed has been chosen correctly and the 2-stage closing law of the wicket gate promoted in this case is effective in such situations.

  10. OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE - A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gordon Tibbitts; Arnis Judzis

    2002-07-01

    This document details the progress to date on the OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE -- A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING contract for the quarter starting April 2002 through June 2002. Even though we are awaiting the optimization portion of the testing program, accomplishments include the following: (1) Presentation material was provided to the DOE/NETL project manager (Dr. John Rogers) for the DOE exhibit at the 2002 Offshore Technology Conference. (2) Two meeting at Smith International and one at Andergauge in Houston were held to investigate their interest in joining the Mud Hammer Performancemore » study. (3) SDS Digger Tools (Task 3 Benchmarking participant) apparently has not negotiated a commercial deal with Halliburton on the supply of fluid hammers to the oil and gas business. (4) TerraTek is awaiting progress by Novatek (a DOE contractor) on the redesign and development of their next hammer tool. Their delay will require an extension to TerraTek's contracted program. (5) Smith International has sufficient interest in the program to start engineering and chroming of collars for testing at TerraTek. (6) Shell's Brian Tarr has agreed to join the Industry Advisory Group for the DOE project. The addition of Brian Tarr is welcomed as he has numerous years of experience with the Novatek tool and was involved in the early tests in Europe while with Mobil Oil. (7) Conoco's field trial of the Smith fluid hammer for an application in Vietnam was organized and has contributed to the increased interest in their tool.« less

  11. Correlation of the manual compaction hammer with mechanical hammers for the Marshall method of design for asphaltic concrete.

    DOT National Transportation Integrated Search

    1964-09-01

    The purpose of this investigation was to establish, through a series of correlations, the compactive effort (number of blows) needed using the mechanical hammers to yield similar physical properties obtained with 75 blows of the manual hammer.

  12. OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE--A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Arnis Judzis

    2004-07-01

    This document details the progress to date on the ''OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE--A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING'' contract for the quarter starting April 2004 through June 2004. The DOE and TerraTek continue to wait for Novatek on the optimization portion of the testing program (they are completely rebuilding their fluid hammer). The latest indication is that the Novatek tool would be ready for retesting only 4Q 2004 or later. Smith International's hammer was tested in April of 2004 (2Q 2004 report). Accomplishments included the following: (1) TerraTek re-tested the ''optimized'' fluid hammermore » provided by Smith International during April 2004. Many improvements in mud hammer rates of penetration were noted over Phase 1 benchmark testing from November 2002. (2) Shell Exploration and Production in The Hague was briefed on various drilling performance projects including Task 8 ''Cutter Impact Testing''. Shell interest and willingness to assist in the test matrix as an Industry Advisor is appreciated. (3) TerraTek participated in a DOE/NETL Review meeting at Morgantown on April 15, 2004. The discussions were very helpful and a program related to the Mud Hammer optimization project was noted--Terralog modeling work on percussion tools. (4) Terralog's Dr. Gang Han witnessed some of the full-scale optimization testing of the Smith International hammer in order to familiarize him with downhole tools. TerraTek recommends that modeling first start with single cutters/inserts and progress in complexity. (5) The final equipment problem on the impact testing task was resolved through the acquisition of a high data rate laser based displacement instrument. (6) TerraTek provided Novatek much engineering support for the future re-testing of their optimized tool. Work was conducted on slip ring [electrical] specifications and tool collar sealing in the testing vessel with a reconfigured flow system on Novatek's collar.« less

  13. Influences on water-hammer wave shape: an experimental study

    NASA Astrophysics Data System (ADS)

    Traudt, T.; Bombardieri, C.; Manfletti, C.

    2016-09-01

    Water-hammer phenomena are of strong interest in a number of different industrial fields, amongst which the space industry. Here the priming of feedlines during start-up of an engine as well as the rapid closing of valves upon shutdown may lead to pressure peaks symptomatic of a water-hammer wave. Test benches used to conduct tests on future as well as current engines are also sensitive to water-hammer waves traveling along their feedlines. To enhance the understanding of water-hammer, we investigated different configurations and their influence on the wave shape in the frequency domain. The configurations feature a coiled pipe setup with a support structure and without a support structure. Two other phenomena will be presented. We found a beat phenomenon which is likely to be the so called Poisson-coupling beat. Finally we will show that the second water-hammer peak can reach pressures a lot higher than the first peak by additive interference of the primary and secondary water-hammer wave.

  14. Development of a Piezoelectric Rotary Hammer Drill

    NASA Technical Reports Server (NTRS)

    Domm, Lukas N.

    2011-01-01

    The Piezoelectric Rotary Hammer Drill is designed to core through rock using a combination of rotation and high frequency hammering powered by a single piezoelectric actuator. It is designed as a low axial preload, low mass, and low power device for sample acquisition on future missions to extraterrestrial bodies. The purpose of this internship is to develop and test a prototype of the Piezoelectric Rotary Hammer Drill in order to verify the use of a horn with helical or angled cuts as a hammering and torque inducing mechanism. Through an iterative design process using models in ANSYS Finite Element software and a Mason's Equivalent Circuit model in MATLAB, a horn design was chosen for fabrication based on the predicted horn tip motion, electromechanical coupling, and neutral plane location. The design was then machined and a test bed assembled. The completed prototype has proven that a single piezoelectric actuator can be used to produce both rotation and hammering in a drill string through the use of a torque inducing horn. Final data results include bit rotation produced versus input power, and best drilling rate achieved with the prototype.

  15. Infrasound Generation from the HH Seismic Hammer.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jones, Kyle Richard

    2014-10-01

    The HH Seismic hammer is a large, "weight-drop" source for active source seismic experiments. This system provides a repetitive source that can be stacked for subsurface imaging and exploration studies. Although the seismic hammer was designed for seismological studies it was surmised that it might produce energy in the infrasonic frequency range due to the ground motion generated by the 13 metric ton drop mass. This study demonstrates that the seismic hammer generates a consistent acoustic source that could be used for in-situ sensor characterization, array evaluation and surface-air coupling studies for source characterization.

  16. Effect of hammer mass on upper extremity joint moments.

    PubMed

    Balendra, Nilanthy; Langenderfer, Joseph E

    2017-04-01

    This study used an OpenSim inverse-dynamics musculoskeletal model scaled to subject-specific anthropometrics to calculate three-dimensional intersegmental moments at the shoulder, elbow and wrist while 10 subjects used 1 and 2 lb hammers to drive nails. Motion data were collected via an optoelectronic system and the interaction of the hammer with nails was recorded with a force plate. The larger hammer caused substantial increases (50-150%) in moments, although increases differed by joint, anatomical component, and significance of the effect. Moment increases were greater in cocking and strike/follow-through phases as opposed to swinging and may indicate greater potential for injury. Compared to shoulder, absolute increases in peak moments were smaller for elbow and wrist, but there was a trend toward larger relative increases for distal joints. Shoulder rotation, elbow varus-valgus and pronation-supination, and wrist radial-ulnar deviation and rotation demonstrated large relative moment increases. Trial and phase durations were greater for the larger hammer. Changes in moments and timing indicate greater loads on musculoskeletal tissues for an extended period with the larger hammer. Additionally, greater variability in timing with the larger hammer, particularly for cocking phase, suggests differences in control of the motion. Increased relative moments for distal joints may be particularly important for understanding disorders of the elbow and wrist associated with hammer use. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. View of hammer nameplate (Chambersburg Engineering Company, Chambersburg, Penna USA) ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View of hammer nameplate (Chambersburg Engineering Company, Chambersburg, Penna USA) and view north of Tony Talotta (heavy forger), Paul Azcharka (hammer operator), and Morty Hoffman (hammer operator helper) forging eyebolts. - Naval Base Philadelphia-Philadelphia Naval Shipyard, Structure Shop, League Island, Philadelphia, Philadelphia County, PA

  18. Variable Step Integration Coupled with the Method of Characteristics Solution for Water-Hammer Analysis, A Case Study

    NASA Technical Reports Server (NTRS)

    Turpin, Jason B.

    2004-01-01

    One-dimensional water-hammer modeling involves the solution of two coupled non-linear hyperbolic partial differential equations (PDEs). These equations result from applying the principles of conservation of mass and momentum to flow through a pipe, and usually the assumption that the speed at which pressure waves propagate through the pipe is constant. In order to solve these equations for the interested quantities (i.e. pressures and flow rates), they must first be converted to a system of ordinary differential equations (ODEs) by either approximating the spatial derivative terms with numerical techniques or using the Method of Characteristics (MOC). The MOC approach is ideal in that no numerical approximation errors are introduced in converting the original system of PDEs into an equivalent system of ODEs. Unfortunately this resulting system of ODEs is bound by a time step constraint so that when integrating the equations the solution can only be obtained at fixed time intervals. If the fluid system to be modeled also contains dynamic components (i.e. components that are best modeled by a system of ODEs), it may be necessary to take extremely small time steps during certain points of the model simulation in order to achieve stability and/or accuracy in the solution. Coupled together, the fixed time step constraint invoked by the MOC, and the occasional need for extremely small time steps in order to obtain stability and/or accuracy, can greatly increase simulation run times. As one solution to this problem, a method for combining variable step integration (VSI) algorithms with the MOC was developed for modeling water-hammer in systems with highly dynamic components. A case study is presented in which reverse flow through a dual-flapper check valve introduces a water-hammer event. The predicted pressure responses upstream of the check-valve are compared with test data.

  19. Long-term follow-up of hypothenar hammer syndrome: a series of 47 patients.

    PubMed

    Marie, Isabelle; Hervé, Fabien; Primard, Etienne; Cailleux, Nicole; Levesque, Hervé

    2007-11-01

    Hypothenar hammer syndrome (HHS) is an uncommon form of secondary Raynaud phenomenon, occurring mainly in subjects who use the hypothenar part of the hand as a hammer; the hook of the hamate strikes the superficial palmar branch of the ulnar artery in the Guyon space, leading to occlusion and/or aneurysm of the ulnar artery. In patients with HHS, such injuries of the palmar ulnar artery may lead to severe vascular insufficiency in the hand with occlusion of digital artery. To date, only a few series have analyzed the long-term outcome of patients with HHS. This prompted us to conduct the current retrospective study to 1) evaluate the prevalence of HHS in patients with Raynaud phenomenon and 2) assess the short-term and long-term outcome in patients with HHS. From 1990 to 2006, 4148 consecutive patients were referred to the Department of Internal Medicine at the University of Rouen medical center for evaluation of Raynaud phenomenon using nailfold capillaroscopy. HHS was diagnosed in 47 of these 4148 patients (1.13% of cases).Forty-three patients (91.5%) had occupational exposure to repetitive palmar trauma. The more common occupations were factory worker (21.3%), mason (12.8%), carpenter (10.6%), and metal worker (10.6%); the mean duration of occupational exposure to repetitive palmar trauma at HHS diagnosis was 21 years. One patient (2.1%) had recreational exposure (aikido training) to repetitive trauma of the palmar ulnar artery, and 3 other patients (6.4%) developed HHS related to a single direct injury to the hypothenar area. Clinical manifestations were more often unilateral (87.2%) involving the dominant hand (93%). HHS complications included digital ischemic symptoms (ischemia: n = 21, necrosis: n = 20) and irritation of the sensory branch of the ulnar nerve (n = 11). In HHS patients, angiography demonstrated occlusion of the ulnar artery in the area of the Guyon space (59.6%), aneurysm of the ulnar artery in the area of the Guyon space (40.4%), and embolic

  20. Vibration and recoil control of pneumatic hammers. [by air flow pressure regulation

    NASA Technical Reports Server (NTRS)

    Constantinescu, I. N.; Darabont, A. V.

    1974-01-01

    Vibration sources are described for pneumatic hammers used in the mining industry (pick hammers), in boiler shops (riveting hammers), etc., bringing to light the fact that the principal vibration source is the variation in air pressure inside the cylinder. The present state of the art of vibration control of pneumatic hammers as it is practiced abroad, and the solutions adopted for this purpose, are discussed. A new type of pneumatic hammer with a low noise and vibration level is presented.

  1. Voice Coil Percussive Mechanism Concept for Hammer Drill

    NASA Technical Reports Server (NTRS)

    Okon, Avi

    2009-01-01

    A hammer drill design of a voice coil linear actuator, spring, linear bearings, and a hammer head was proposed. The voice coil actuator moves the hammer head to produce impact to the end of the drill bit. The spring is used to store energy on the retraction and to capture the rebound energy after each impact for use in the next impact. The maximum actuator stroke is 20 mm with the hammer mass being 200 grams. This unit can create impact energy of 0.4 J with 0.8 J being the maximum. This mechanism is less complex than previous devices meant for the same task, so it has less mass and less volume. Its impact rate and energy are easily tunable without changing major hardware components. The drill can be driven by two half-bridges. Heat is removed from the voice coil via CO2 conduction.

  2. Reconstruction of piano hammer force from string velocity.

    PubMed

    Chaigne, Antoine

    2016-11-01

    A method is presented for reconstructing piano hammer forces through appropriate filtering of the measured string velocity. The filter design is based on the analysis of the pulses generated by the hammer blow and propagating along the string. In the five lowest octaves, the hammer force is reconstructed by considering two waves only: the incoming wave from the hammer and its first reflection at the front end. For the higher notes, four- or eight-wave schemes must be considered. The theory is validated on simulated string velocities by comparing imposed and reconstructed forces. The simulations are based on a nonlinear damped stiff string model previously developed by Chabassier, Chaigne, and Joly [J. Acoust. Soc. Am. 134(1), 648-665 (2013)]. The influence of absorption, dispersion, and amplitude of the string waves on the quality of the reconstruction is discussed. Finally, the method is applied to real piano strings. The measured string velocity is compared to the simulated velocity excited by the reconstructed force, showing a high degree of accuracy. A number of simulations are compared to simulated strings excited by a force derived from measurements of mass and acceleration of the hammer head. One application to an historic piano is also presented.

  3. OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE - A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gordon Tibbitts; Arnis Judzis

    2002-04-01

    This document details the progress to date on the OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE--A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING contract for the quarter starting January 2002 through March 2002. Accomplishments include the following: In accordance to Task 7.0 (D. No.2 Technical Publications) TerraTek, NETL, and the Industry Contributors successfully presented a paper detailing Phase 1 testing results at the February 2002 IADC/SPE Drilling Conference, a prestigious venue for presenting DOE and private sector drilling technology advances. The full reference is as follows: (1) IADC/SPE 74540 ''World's First Benchmarking of Drilling Mud Hammer Performance atmore » Depth Conditions'' authored by Gordon A. Tibbitts, TerraTek; Roy C. Long, US Department of Energy, Brian E. Miller, BP America, Inc.; Arnis Judzis, TerraTek; and Alan D. Black, TerraTek. Gordon Tibbitts, TerraTek, will presented the well-attended paper in February of 2002. The full text of the Mud Hammer paper was included in the last quarterly report. (2) The Phase 2 project planning meeting (Task 6) was held at ExxonMobil's Houston Greenspoint offices on February 22, 2002. In attendance were representatives from TerraTek, DOE, BP, ExxonMobil, PDVSA, Novatek, and SDS Digger Tools. (3) PDVSA has joined the advisory board to this DOE mud hammer project. PDVSA's commitment of cash and in-kind contributions were reported during the last quarter. (4) Strong Industry support remains for the DOE project. Both Andergauge and Smith Tools have expressed an interest in participating in the ''optimization'' phase of the program. The potential for increased testing with additional Industry cash support was discussed at the planning meeting in February 2002.« less

  4. OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE - A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gordon Tibbitts; Arnis Judzis

    2001-10-01

    This document details the progress to date on the OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE -- A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING contract for the quarter starting July 2001 through September 2001. Accomplishments to date include the following: TerraTek highlighted DOE's National Energy Technology Laboratory effort on Mud Hammer Optimization at the recent Annual Conference and Exhibition for the Society of Petroleum Engineers. The original exhibit scheduled by NETL was canceled due to events surrounding the September tragedies in the US. TerraTek has completed analysis of drilling performance (rates of penetration, hydraulics, etc.) for themore » Phase One testing which was completed at the beginning of July. TerraTek jointly with the Industry Advisory Board for this project and DOE/NETL conducted a lessons learned meeting to transfer technology vital for the next series of performance tests. Both hammer suppliers benefited from the testing program and are committed to pursue equipment improvements and ''optimization'' in accordance with the scope of work. An abstract for a proposed publication by the society of Petroleum Engineers/International Association of Drilling Contractors jointly sponsored Drilling Conference was accepted as an alternate paper. Technology transfer is encouraged by the DOE in this program, thus plans are underway to prepare the paper for this prestigious venue.« less

  5. Screening reactor steam/water piping systems for water hammer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Griffith, P.

    1997-09-01

    A steam/water system possessing a certain combination of thermal, hydraulic and operational states, can, in certain geometries, lead to a steam bubble collapse induced water hammer. These states, operations, and geometries are identified. A procedure that can be used for identifying whether an unbuilt reactor system is prone to water hammer is proposed. For the most common water hammer, steam bubble collapse induced water hammer, six conditions must be met in order for one to occur. These are: (1) the pipe must be almost horizontal; (2) the subcooling must be greater than 20 C; (3) the L/D must be greatermore » than 24; (4) the velocity must be low enough so that the pipe does not run full, i.e., the Froude number must be less than one; (5) there should be void nearby; (6) the pressure must be high enough so that significant damage occurs, that is the pressure should be above 10 atmospheres. Recommendations on how to avoid this kind of water hammer in both the design and the operation of the reactor system are made.« less

  6. When does tool use become distinctively human?: Hammering in young children

    PubMed Central

    Kahrs, Björn; Lockman, Jeffrey J.; Jung, Wendy

    2013-01-01

    This study examines the development of hammering within an ontogenetic and evolutionary framework using motion-capture technology. Twenty-four right-handed toddlers (19–35 months) wore reflective markers while hammering a peg into a peg-board. The study focuses on the motor characteristics that make tool use uniquely human: wrist involvement, lateralization, and handle use. Older children showed more distally controlled movements, characterized by relatively more reliance on the wrist, but only when hammering with their right hand. Greater age, use of the right hand, and more wrist involvement were associated with higher accuracy; handle use did not systematically change with age. Collectively, the results provide new insights about the emergence of hammering in young children and when hammering begins to manifest distinctively human characteristics. PMID:24128178

  7. Do chimpanzees use weight to select hammer tools?

    PubMed

    Schrauf, Cornelia; Call, Josep; Fuwa, Koki; Hirata, Satoshi

    2012-01-01

    The extent to which tool-using animals take into account relevant task parameters is poorly understood. Nut cracking is one of the most complex forms of tool use, the choice of an adequate hammer being a critical aspect in success. Several properties make a hammer suitable for nut cracking, with weight being a key factor in determining the impact of a strike; in general, the greater the weight the fewer strikes required. This study experimentally investigated whether chimpanzees are able to encode the relevance of weight as a property of hammers to crack open nuts. By presenting chimpanzees with three hammers that differed solely in weight, we assessed their ability to relate the weight of the different tools with their effectiveness and thus select the most effective one(s). Our results show that chimpanzees use weight alone in selecting tools to crack open nuts and that experience clearly affects the subjects' attentiveness to the tool properties that are relevant for the task at hand. Chimpanzees can encode the requirements that a nut-cracking tool should meet (in terms of weight) to be effective.

  8. A body is not a metaphor: Barbara Hammer's X-ray vision.

    PubMed

    Osterweil, Ara

    2010-01-01

    This article examines three films by legendary experimental filmmaker Barbara Hammer that deal with the sick, aging, or dying body: Optic Nerve (1985), Sanctus (1990), and A Horse is Not a Metaphor (2008). By analyzing films that do not explicitly confront sexual identity, this article questions the continuing usefulness of the designation "lesbian filmmaker" when considering Hammer's diverse body of work. Tracing the "double consciousness" through which Hammer approaches the body and its construction in patriarchy-particularly in the discourse of medicine-this article argues that Hammer's is a thoroughly corporeal, but not exclusively lesbian, cinema.

  9. The Hammer-and-Nail Phenomenon in Mathematics Education

    ERIC Educational Resources Information Center

    Lim, Kien H.

    2012-01-01

    This paper uses the hammer-and-nail metaphor to highlight the rigidity and impulsiveness that can be found in student mathematical behaviour. The hammer-and-nail phenomenon can be attributed to two plausible causes: (1) the way the human mind works; and (2) the way mathematics is traditionally taught in school. In this paper, the following aspects…

  10. An Analysis of the Impact of Valve Closure Time on the Course of Water Hammer

    NASA Astrophysics Data System (ADS)

    Kodura, Apoloniusz

    2016-06-01

    The knowledge of transient flow in pressure pipelines is very important for the designing and describing of pressure networks. The water hammer is the most common example of transient flow in pressure pipelines. During this phenomenon, the transformation of kinetic energy into pressure energy causes significant changes in pressure, which can lead to serious problems in the management of pressure networks. The phenomenon is very complex, and a large number of different factors influence its course. In the case of a water hammer caused by valve closing, the characteristic of gate closure is one of the most important factors. However, this factor is rarely investigated. In this paper, the results of physical experiments with water hammer in steel and PE pipelines are described and analyzed. For each water hammer, characteristics of pressure change and valve closing were recorded. The measurements were compared with the results of calculations perfomed by common methods used by engineers - Michaud's equation and Wood and Jones's method. The comparison revealed very significant differences between the results of calculations and the results of experiments. In addition, it was shown that, the characteristic of butterfly valve closure has a significant influence on water hammer, which should be taken into account in analyzing this phenomenon. Comparison of the results of experiments with the results of calculations? may lead to new, improved calculation methods and to new methods to describe transient flow.

  11. CFD Analysis of the Anti-Surge Effects by Water Hammering

    NASA Astrophysics Data System (ADS)

    Kim, Tae-oh; Jeong, Hyo-min; Chung, Han-shik; Lee, Sin-il; Lee, Kwang-sung

    2015-09-01

    Water hammering occurs due to the surge effect that comes from operating the pump, sudden stop during the operating due to a blackout and rapid open and close of the valve. By the water hammering of the pipeline and the pump, the valve are damaged. In this paper, transient analysis is conducted by CFD (Computational Fluid Dynamics). The purpose of this paper is to provide the research data about the change of the pressure and flow in the pipe that caused by the water hammering.

  12. Proximal forearm extensor muscle strain is reduced when driving nails using a shock-controlled hammer.

    PubMed

    Buchanan, Kimberly A; Maza, Maria; Pérez-Vázquez, Carlos E; Yen, Thomas Y; Kijowski, Richard; Liu, Fang; Radwin, Robert G

    2016-10-01

    Repetitive hammer use has been associated with strain and musculoskeletal injuries. This study investigated if using a shock-control hammer reduces forearm muscle strain by observing adverse physiological responses (i.e. inflammation and localized edema) after use. Three matched framing hammers were studied, including a wood-handle, steel-handle, and shock-control hammer. Fifty volunteers were randomly assigned to use one of these hammers at a fatiguing pace of one strike every second, to seat 20 nails in a wood beam. Magnetic resonance imaging was used to scan the forearm muscles for inflammation before the task, immediately after hammering, and one to two days after. Electromyogram signals were measured to estimate grip exertions and localized muscle fatigue. High-speed video was used to calculate the energy of nail strikes. While estimated grip force was similar across the three hammers, the shock-control hammer had 40% greater kinetic energy upon impact and markedly less proximal extensor muscle edema than the wood-handle and steel-handle hammers, immediately after use (p<.05). Less edema observed for the shock-control hammer suggests that isolating handle shock can mitigate strain in proximal forearm extensor muscles. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Improved ATLAS HammerCloud Monitoring for Local Site Administration

    NASA Astrophysics Data System (ADS)

    Böhler, M.; Elmsheuser, J.; Hönig, F.; Legger, F.; Mancinelli, V.; Sciacca, G.

    2015-12-01

    Every day hundreds of tests are run on the Worldwide LHC Computing Grid for the ATLAS, and CMS experiments in order to evaluate the performance and reliability of the different computing sites. All this activity is steered, controlled, and monitored by the HammerCloud testing infrastructure. Sites with failing functionality tests are auto-excluded from the ATLAS computing grid, therefore it is essential to provide a detailed and well organized web interface for the local site administrators such that they can easily spot and promptly solve site issues. Additional functionality has been developed to extract and visualize the most relevant information. The site administrators can now be pointed easily to major site issues which lead to site blacklisting as well as possible minor issues that are usually not conspicuous enough to warrant the blacklisting of a specific site, but can still cause undesired effects such as a non-negligible job failure rate. This paper summarizes the different developments and optimizations of the HammerCloud web interface and gives an overview of typical use cases.

  14. Modelling water hammer in viscoelastic pipelines: short brief

    NASA Astrophysics Data System (ADS)

    Urbanowicz, K.; Firkowski, M.; Zarzycki, Z.

    2016-10-01

    The model of water hammer in viscoelastic pipelines is analyzed. An appropriate mathematical model of water hammer in polymer pipelines is presented. An additional term has been added to continuity equation to describe the retarded deformation of the pipe wall. The mechanical behavior of viscoelastic material is described by generalized Kelvin-Voigt model. The comparison of numerical simulation and experimental data from well known papers is presented. Short discussion about obtained results are given.

  15. A Hammer-Impact, Aluminum, Shear-Wave Seismic Source

    USGS Publications Warehouse

    Haines, Seth

    2007-01-01

    Near-surface seismic surveys often employ hammer impacts to create seismic energy. Shear-wave surveys using horizontally polarized waves require horizontal hammer impacts against a rigid object (the source) that is coupled to the ground surface. I have designed, built, and tested a source made out of aluminum and equipped with spikes to improve coupling. The source is effective in a variety of settings, and it is relatively simple and inexpensive to build.

  16. HammerCloud: A Stress Testing System for Distributed Analysis

    NASA Astrophysics Data System (ADS)

    van der Ster, Daniel C.; Elmsheuser, Johannes; Úbeda García, Mario; Paladin, Massimo

    2011-12-01

    Distributed analysis of LHC data is an I/O-intensive activity which places large demands on the internal network, storage, and local disks at remote computing facilities. Commissioning and maintaining a site to provide an efficient distributed analysis service is therefore a challenge which can be aided by tools to help evaluate a variety of infrastructure designs and configurations. HammerCloud is one such tool; it is a stress testing service which is used by central operations teams, regional coordinators, and local site admins to (a) submit arbitrary number of analysis jobs to a number of sites, (b) maintain at a steady-state a predefined number of jobs running at the sites under test, (c) produce web-based reports summarizing the efficiency and performance of the sites under test, and (d) present a web-interface for historical test results to both evaluate progress and compare sites. HammerCloud was built around the distributed analysis framework Ganga, exploiting its API for grid job management. HammerCloud has been employed by the ATLAS experiment for continuous testing of many sites worldwide, and also during large scale computing challenges such as STEP'09 and UAT'09, where the scale of the tests exceeded 10,000 concurrently running and 1,000,000 total jobs over multi-day periods. In addition, HammerCloud is being adopted by the CMS experiment; the plugin structure of HammerCloud allows the execution of CMS jobs using their official tool (CRAB).

  17. Design of a water-powered DTH hammer for deep drilling application

    NASA Astrophysics Data System (ADS)

    Cho, Min Jae; Kim, Donguk; Oh, Joo Young; Yook, Se-Jin; Kim, Young Won

    2017-11-01

    A DTH (Down-the-hole) hammer powered by highly pressurized fluid is a drilling tool using the motion of percussion of a drill bit. In retrospect, a DTH by using compressed air as a power source has been widely used in drilling industries such as applications of mining, geothermal etc. On the other hand, another type of a DTH that uses pressurized water, called a water hammer, has recently seen deep drilling applications, while it has been rarely investigated. In this study, we designed a water-powered DTH hammer which mainly consists of several components such as a piston, a poppet valve, a cap and a bit for deep drilling applications. We optimized the components of the hammer on the basis of the results of 1D analysis using commercial software of AMESIM. An experimental study has been also conducted to investigate a performance of the designed water hammer. We measured a pressure distribution inside the hammer system as a function of time, and it thus estimates a frequency of impaction of the bit, which has been also analyzed in frequency domain. In addition, some important parameters have been discussed in conjunction with a limitation of impaction frequency as input pressure. We believe that this study provides design rules of a water-based DTH for deep drilling applications. This work is supported by KITECH of Korean government.

  18. OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE - A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gordon Tibbitts; Arnis Judzis

    2001-04-01

    This document details the progress to date on the OPTIMIZATION OF MUD HAMMER DRILLING PERFORMANCE -- A PROGRAM TO BENCHMARK THE VIABILITY OF ADVANCED MUD HAMMER DRILLING contract for the quarter starting January 2001 through March 2001. Accomplishments to date include the following: (1) On January 9th of 2001, details of the Mud Hammer Drilling Performance Testing Project were presented at a ''kick-off'' meeting held in Morgantown. (2) A preliminary test program was formulated and prepared for presentation at a meeting of the advisory board in Houston on the 8th of February. (3) The meeting was held with the advisorymore » board reviewing the test program in detail. (4) Consensus was achieved and the approved test program was initiated after thorough discussion. (5) This new program outlined the details of the drilling tests as well as scheduling the test program for the weeks of 14th and 21st of May 2001. (6) All the tasks were initiated for a completion to coincide with the test schedule. (7) By the end of March the hardware had been designed and the majority was either being fabricated or completed. (8) The rock was received and cored into cylinders.« less

  19. Effects of air vessel on water hammer in high-head pumping station

    NASA Astrophysics Data System (ADS)

    Wang, L.; Wang, F. J.; Zou, Z. C.; Li, X. N.; Zhang, J. C.

    2013-12-01

    Effects of air vessel on water hammer process in a pumping station with high-head were analyzed by using the characteristics method. The results show that the air vessel volume is the key parameter that determines the protective effect on water hammer pressure. The maximum pressure in the system declines with increasing air vessel volume. For a fixed volume of air vessel, the shape of air vessel and mounting style, such as horizontal or vertical mounting, have little effect on the water hammer. In order to obtain good protection effects, the position of air vessel should be close to the outlet of the pump. Generally, once the volume of air vessel is guaranteed, the water hammer of a entire pipeline is effectively controlled.

  20. Laboratory and field measurements and evaluations of vibration at the handles of riveting hammers

    PubMed Central

    McDOWELL, THOMAS W.; WARREN, CHRISTOPHER; WELCOME, DANIEL E.; DONG, REN G.

    2015-01-01

    The use of riveting hammers can expose workers to harmful levels of hand-transmitted vibration (HTV). As a part of efforts to reduce HTV exposures through tool selection, the primary objective of this study was to evaluate the applicability of a standardized laboratory-based riveting hammer assessment protocol for screening riveting hammers. The second objective was to characterize the vibration emissions of reduced vibration riveting hammers and to make approximations of the HTV exposures of workers operating these tools in actual work tasks. Eight pneumatic riveting hammers were selected for the study. They were first assessed in a laboratory using the standardized method for measuring vibration emissions at the tool handle. The tools were then further assessed under actual working conditions during three aircraft sheet metal riveting tasks. Although the average vibration magnitudes of the riveting hammers measured in the laboratory test were considerably different from those measured in the field study, the rank orders of the tools determined via these tests were fairly consistent, especially for the lower vibration tools. This study identified four tools that consistently exhibited lower frequency-weighted and unweighted accelerations in both the laboratory and workplace evaluations. These observations suggest that the standardized riveting hammer test is acceptable for identifying tools that could be expected to exhibit lower vibrations in workplace environments. However, the large differences between the accelerations measured in the laboratory and field suggest that the standardized laboratory-based tool assessment is not suitable for estimating workplace riveting hammer HTV exposures. Based on the frequency-weighted accelerations measured at the tool handles during the three work tasks, the sheet metal mechanics assigned to these tasks at the studied workplace are unlikely to exceed the daily vibration exposure action value (2.5 m s−2) using any of the

  1. The use of titanium alloys for details of downhole hammers

    NASA Astrophysics Data System (ADS)

    Popelyukh, A. I.; Repin, A. A.; Alekseev, S. E.; Martyushev, N. V.; Drozdov, Yu Yu

    2016-04-01

    The influence of cementation technology of titanium alloy Ti-Al-Mn on its wear resistance is studied. It is established that after lubrication a friction pair with mineral oil the wear resistance of the cemented titanium alloy is comparable to wear resistance of the tempered steel 12HN3A, and in water medium surpasses it by 1.5 times. Decrease in the tendency to seizure with steel is the main reason for increase of wear resistance of titanium alloy. Industrial tests of the ASH43 hammer have shown that the use of titanium alloys for the manufacture of hammer strikers allows to increase impact capacity by 1.5 times and to increase drilling rate by 30 % compared to hammers with steel strikers.

  2. Understanding the effect of hammering process on the vibration characteristics of cymbals

    NASA Astrophysics Data System (ADS)

    Kuratani, F.; Yoshida, T.; Koide, T.; Mizuta, T.; Osamura, K.

    2016-09-01

    Cymbals are thin domed plates used as percussion instruments. When cymbals are struck, they vibrate and radiate sound. Cymbals are made through spin forming, hammering, and lathing. The spin forming creates the basic shape of the cymbal, which determines its basic vibration characteristics. The hammering and lathing produce specific sound adjustments by changing the cymbal's vibration characteristics. In this study, we study how hammering cymbals affects their vibration characteristics. The hammering produces plastic deformation (small, shallow dents) on the cymbal's surface, generating residual stresses throughout it. These residual stresses change the vibration characteristics. We perform finite element analysis of a cymbal to obtain its stress distribution and the resulting change in vibration characteristics. To reproduce the stress distribution, we use thermal stress analysis, and then with this stress distribution we perform vibration analysis. These results show that each of the cymbal's modes has a different sensitivity to the thermal load (i.e., hammering). This difference causes changes in the frequency response and the deflection shape that significantly improves the sound radiation efficiency. In addition, we explain the changes in natural frequencies by the stress and modal strain energy distributions.

  3. Auto-Gopher-II: an autonomous wireline rotary-hammer ultrasonic drill

    NASA Astrophysics Data System (ADS)

    Badescu, Mircea; Lee, Hyeong Jae; Sherrit, Stewart; Bao, Xiaoqi; Bar-Cohen, Yoseph; Jackson, Shannon; Chesin, Jacob; Zacny, Kris; Paulsen, Gale L.; Mellerowicz, Bolek; Kim, Daniel

    2017-04-01

    Developing technologies that would enable future NASA exploration missions to penetrate deeper into the subsurface of planetary bodies for sample collection is of great importance. Performing these tasks while using minimal mass/volume systems and with low energy consumption is another set of requirements imposed on such technologies. A deep drill, called Auto-Gopher II, is currently being developed as a joint effort between JPL's NDEAA laboratory and Honeybee Robotics Corp. The Auto-Gopher II is a wireline rotary-hammer drill that combines formation breaking by hammering using an ultrasonic actuator and cuttings removal by rotating a fluted auger bit. The hammering mechanism is based on the Ultrasonic/Sonic Drill/Corer (USDC) mechanism that has been developed as an adaptable tool for many drilling and coring applications. The USDC uses an intermediate free-flying mass to transform high frequency vibrations of a piezoelectric transducer horn tip into sonic hammering of the drill bit. The USDC concept was used in a previous task to develop an Ultrasonic/Sonic Ice Gopher and then integrated into a rotary hammer device to develop the Auto-Gopher-I. The lessons learned from these developments are being integrated into the development of the Auto- Gopher-II, an autonomous deep wireline drill with integrated cuttings and sample management and drive electronics. Subsystems of the wireline drill are being developed in parallel at JPL and Honeybee Robotics Ltd. This paper presents the development efforts of the piezoelectric actuator, cuttings removal and retention flutes and drive electronics.

  4. Comparison of Piezosurgery and Hammer-Chisel in Endoscopic Dacryocystorhinostomy.

    PubMed

    Çukurova, Ibrahim; Bulğurcu, Suphi; Arslan, Ilker Burak; Dikilitaş, Bünyamin

    2018-05-08

    In this study, we compared the advantages and disadvantages of piezosurgery and hammer-chisel used in endoscopic dacryocystorhinostomy (EDCR). Between January 2012 and January 2016, 10 women and 8 men in whom piezosurgery was used (group 1) and 11 women and 7 men in whom hammer-chisel was used (group 2) during EDCR operations were compared retrospectively. Recurrence, operation time, postoperative bleeding, and operative cost were evaluated in patients who were followed for an average of 11.8 months. In addition, visual analogue scale (VAS) was used to assess pain at 6 hours postoperatively. No recurrence was observed in group 1, but recurrence was observed in 2 patients in group 2 (P = 0.685). There was no postoperative bleeding in both groups. The mean duration of operation was 30.6 ± 8.2 minutes in group 1 and 46.8 ± 9.5 minutes in group 2 (P = 0.038). The VAS score in group 1 was 2.7 ± 1.4 and the VAS score in group 2 was 5.8 ± 2.2 (P = 0.01). Piezosurgery costs an additional $325 for each patient while the use of the hammer-chisel does not incur additional costs. Piezosurgery causes shorter operation time, less recurrence, and less pain when compared with hammer-chisel.

  5. Bertolotti's syndrome: a case report.

    PubMed

    Mitra, Raj; Carlisle, Mark

    2009-01-01

    A case report and literature review is presented. To review relevant data for the management of Bertolotti's syndrome and to determine whether the transverse process-ilium articulation may be a pain generator. Bertolotti's syndrome is associated with axial low back pain secondary to arthritic changes; the pain generator in the disorder is unclear. We present a case report of symptomatic Bertolotti's syndrome managed with intra-articular steroid injections. A patient with Bertolotti's syndrome had significant relief of axial pain after steroid injection of the ilium-transverse process articulation. Steroid therapy may be a non-surgical alternative for the treatment of symptomatic Bertolotti's syndrome.

  6. When Does Tool Use Become Distinctively Human? Hammering in Young Children

    ERIC Educational Resources Information Center

    Kahrs, Björn Alexander; Jung, Wendy P.; Lockman, Jeffrey J.

    2014-01-01

    This study examines the development of hammering within an ontogenetic and evolutionary framework using motion-capture technology. Twenty-four right-handed toddlers (19-35 months) wore reflective markers while hammering a peg into a peg-board. The study focuses on the motor characteristics that make tool use uniquely human: wrist involvement,…

  7. STUDY ON OPERATING CHARACTERISTECS OF WATER HAMMER GENERATING DEVICE FOR TREATMENT OF MICROORGANISM

    NASA Astrophysics Data System (ADS)

    Hamada, Tatsuhisa; Endo, Shigekatsu; Oda, Akira; Shimizu, Yasushi

    The phenomenon that has been actualized due to the water quality deterioration because of the inflow of drainage and the industrial wastewater includes the phenomenon that is called water-bloom generated in the freshwater environment made a eutrophic. This is becoming a serious problem to secure the water.Mixing with the drinking water has already been confirmed, and the generation of water-bloom is becoming a big social problem, and fundamental measures have not been established yet.On the other hand, authors are proving the pressure to be a fast the pressure speed of the impact pressure by the water hammer and effective in the destruction of the blue-green algae.In this studies, the hydraulics flow characteristics of an effective water hammer pressure generator to the shredding of the water-bloom cell were examined.As a result, there was a boundary in the region where the water hammer was generated by length and the water supply head of conduit, and the water hammer pressure was able to be understood to be influenced according to the angle of the valve that generated the water hammer in addition in the water hammer generator.The demonstration in the locale was confirmed based on these and the scale etc. of an effective device to the doing water-bloom processing were able to be confirmed by continuous running.

  8. 9. VIEW OF 'BLUE STREAK' HAMMER MILL (Prater Pulverizer Co., ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. VIEW OF 'BLUE STREAK' HAMMER MILL (Prater Pulverizer Co., Chicago, Illinois), LOCATED IN THE SOUTHEAST CORNER OF THE BASEMENT, WAS ADDED IN THE EARLY 1930s. THIS WAS THE MILL'S FIRST ELECTRIC-POWERED MACHINERY. THE HAMMER MILL WAS USED TO PULVERIZE OATS, ALFALFA MEAL, AND CORN. Photographer: Louise Taft Cawood, July 1986 - Alexander's Grist Mill, Lock 37 on Ohio & Erie Canal, South of Cleveland, Valley View, Cuyahoga County, OH

  9. Ultrasonic/Sonic Rotary-Hammer Drills

    NASA Technical Reports Server (NTRS)

    Badescu, Mircea; Sherrit, Stewart; Bar-Cohen, Yoseph; Bao, Xiaoqi; Kassab, Steve

    2010-01-01

    Ultrasonic/sonic rotary-hammer drill (USRoHD) is a recent addition to the collection of apparatuses based on ultrasonic/sonic drill corer (USDC). As described below, the USRoHD has several features, not present in a basic USDC, that increase efficiency and provide some redundancy against partial failure. USDCs and related apparatuses were conceived for boring into, and/or acquiring samples of, rock or other hard, brittle materials of geological interest. They have been described in numerous previous NASA Tech Briefs articles. To recapitulate: A USDC can be characterized as a lightweight, lowpower, piezoelectrically driven jackhammer in which ultrasonic and sonic vibrations are generated and coupled to a tool bit. A basic USDC includes a piezoelectric stack, an ultrasonic transducer horn connected to the stack, a free mass ( free in the sense that it can bounce axially a short distance between hard stops on the horn and the bit), and a tool bit. The piezoelectric stack creates ultrasonic vibrations that are mechanically amplified by the horn. The bouncing of the free mass between the hard stops generates the sonic vibrations. The combination of ultrasonic and sonic vibrations gives rise to a hammering action (and a resulting chiseling action at the tip of the tool bit) that is more effective for drilling than is the microhammering action of ultrasonic vibrations alone. The hammering and chiseling actions are so effective that unlike in conventional twist drilling, little applied axial force is needed to make the apparatus advance into the material of interest. There are numerous potential applications for USDCs and related apparatuses in geological exploration on Earth and on remote planets. In early USDC experiments, it was observed that accumulation of cuttings in a drilled hole causes the rate of penetration of the USDC to decrease steeply with depth, and that the rate of penetration can be increased by removing the cuttings. The USRoHD concept provides for

  10. Optimal Control of the Valve Based on Traveling Wave Method in the Water Hammer Process

    NASA Astrophysics Data System (ADS)

    Cao, H. Z.; Wang, F.; Feng, J. L.; Tan, H. P.

    2011-09-01

    Valve regulation is an effective method for process control during the water hammer. The principle of d'Alembert traveling wave theory was used in this paper to construct the exact analytical solution of the water hammer, and the optimal speed law of the valve that can reduce the water hammer pressure in the maximum extent was obtained. Combining this law with the valve characteristic curve, the principle corresponding to the valve opening changing with time was obtained, which can be used to guide the process of valve closing and to reduce the water hammer pressure in the maximum extent.

  11. Naive, captive long-tailed macaques (Macaca fascicularis fascicularis) fail to individually and socially learn pound-hammering, a tool-use behaviour

    PubMed Central

    Tennie, Claudio

    2018-01-01

    A subspecies of long-tailed macaques (Macaca fascicularis aurea; Mfa) has been reported to use stone tools and a specific technique to process nuts in Southeast Asia, a behaviour known as ‘pound-hammering’. The aim of this study was to examine the development of pound-hammering in long-tailed macaques: whether this behavioural form can be individually learnt or whether it has to rely on some forms of social learning. Given the absence of Mfa from captivity, long-tailed macaques of a highly related subspecies (Macaca fascicularis fascicularis; Mff) were experimentally tested by providing them with the ecological materials necessary to show pound-hammering. A baseline was first carried out to observe whether pound-hammering would emerge spontaneously without social information. As this was not the case, different degrees of social information, culminating in a full demonstration of the behaviour, were provided. None of the subjects (n = 31) showed pound-hammering in any of the individual or social learning conditions. Although these data do not support the hypothesis that individual learning underlies this behaviour, no evidence was found that (at least) Mff learn pound-hammering socially either. We propose that other—potentially interacting—factors may determine whether this behaviour emerges in the various subspecies of long-tailed macaques, and provide a novel methodology to test the role of social and individual learning in the development of animal tool-use. PMID:29892375

  12. Automatic hammering of nano-patterns on special polymer film by using a vibrating AFM tip

    PubMed Central

    2012-01-01

    Complicated nano-patterns with linewidth less than 18 nm can be automatically hammered by using atomic force microscopy (AFM) tip in tapping mode with high speed. In this study, the special sample was thin poly(styrene-ethylene/butylenes-styrene) (SEBS) block copolymer film with hexagonal spherical microstructures. An ordinary silicon tip was used as a nano-hammer, and the entire hammering process is controlled by a computer program. Experimental results demonstrate that such structure-tailored thin films enable AFM tip hammering to be performed on their surfaces. Both imprinted and embossed nano-patterns can be generated by using a vibrating tip with a larger tapping load and by using a predefined program to control the route of tip movement as it passes over the sample’s surface. Specific details for the fabrication of structure-tailored SEBS film and the theory for auto-hammering patterns were presented in detail. PMID:22889045

  13. Single Piezo-Actuator Rotary-Hammering (SPaRH) Drill

    NASA Technical Reports Server (NTRS)

    Sherrit, Stewart; Domm, Lukas; Bao, Xiaoqi; Bar-Cohen, Yoseph; Chang, Zensheu; Badescu, Mircea

    2012-01-01

    The search for present or past life in the Universe is one of the most important objectives of NASA's exploration missions. Drills for subsurface sampling of rocks, ice and permafrost are an essential tool for astrobiology studies on other planets. Increasingly, it is recognized that drilling via a combination of rotation and hammering offers an efficient and effective rapid penetration mechanism. The rotation provides an intrinsic method for removal of cuttings from the borehole while the impact and shear forces aids in the fracturing of the penetrated medium. Conventional drills that use a single actuator are based on a complex mechanism with many parts and their use in future mission involves greater risk of failure and/or may require lubrication that can introduce contamination. In this paper, a compact drill is reported that uses a single piezoelectric actuator to produce hammering and rotation of the bit. A horn with asymmetric grooves was design to impart a longitudinal (hammering) and transverse force (rotation) to a keyed free mass. The drill requires low axial pre-load since the hammering-impacts fracture the rock under the bit kerf and rotate the bit to remove the powdered cuttings while augmenting the rock fracture via shear forces. The vibrations 'fluidize' the powdered cuttings inside the flutes reducing the friction with the auger surface. This action reduces the consumed power and heating of the drilled medium helping to preserve the pristine content of the acquired samples. The drill consists of an actuator that simultaneously impacts and rotates the bit by applying force and torque via a single piezoelectric stack actuator without the need for a gearbox or lever mechanism. This can reduce the development/fabrication cost and complexity. In this paper, the drill mechanism will be described and the test results will be reported and discussed.

  14. [On vibration hazards of chipping-hammer operators in an iron foundry. Part 2. Results of the hygienic control].

    PubMed

    Harada, N; Matsumoto, T; Yamada, S; Kobayashi, F

    1982-01-01

    , heavy-headedness, forgetfulness, irritability and hearing disorder showed a tendency for improvement, but other complaints did not (Tables 2-4). The improvement of Raynaud's phenomenon is considered to be due not merely to the countermeasures but also to reducing the chance of provocation and therefore the countermeasures should not be overestimated as a factor of recovery of vibration hazards. Of the functional tests, a tendency for improvement was recognized in sensory functions and peripheral circulatory functions, but not in motor functions (Tables 5, 6). However, the course of recovery was not fast and some advanced cases, especially those using chipping-hammers for more than ten years, showed less improvement after hospital treatment (Table 7, Fig. 1). This indicates the importance of hygienic control which enables vibration hazards patients to have early diagnosis and treatment. Furthermore, in order to eradicate the vibration hazards in the cast metal industry, a drastic reform of the finishing process is considered to be necessary.

  15. [Williams-Beuren syndrome (Williams syndrome). Case report].

    PubMed

    Miklós, Györgyi; Fekete, György; Haltrich, Irén; Tóth, Miklós; Reismann, Péter

    2017-11-01

    Williams syndrome is a rare genetic disorder, that occurs equally in all ethnic groups and both sexes. The diagnosis might be missed during childhood in mild cases. However, establishing the diagnosis is important, not only to find the cause of intellectual disability but to look for cardiovascular, endocrine, psychiatry, urology and other conditions, which can occur at any age in the patients' lifetime. This case report presents the story of 47-year-old woman, who was admitted with haematemesis. During her stay on the ward, in the light of the distinctive facial features, mental retardation, and social behaviour patterns, the possibility of Williams syndrome emerged. Later, the diagnosis was confirmed by genetic analysis. This female is the oldest living patient with Williams syndrome in Hungary. Orv Hetil. 2017; 158(47): 1883-1888.

  16. Concurrent Van der Woude syndrome and Turner syndrome: A case report.

    PubMed

    Los, Evan; Baines, Hayley; Guttmann-Bauman, Ines

    2017-01-01

    Most cases of Van der Woude syndrome are caused by a mutation to interferon regulatory factor 6 on chromosome 1. Turner syndrome is caused by complete or partial absence of the second sex chromosome in girls. We describe a unique case of the two syndromes occurring concurrently though apparently independently in a girl with Van der Woude syndrome diagnosed at birth and Turner syndrome at 14 years 9 months. Short stature was initially misattributed to Van der Woude syndrome and pituitary insufficiency associated with clefts before correctly diagnosing Turner syndrome. We discuss the prevalence of delayed diagnosis of Turner syndrome, the rarity of reports of concurrent autosomal chromosome mutation and sex chromosome deletion, as well as the need to consider the diagnosis of Turner syndrome in all girls with short stature regardless of prior medical history.

  17. Vibration syndrome in chipping and grinding workers.

    PubMed

    1984-10-01

    A clear conclusion from these studies is that vibration syndrome occurs in chipping and grinding workers in this country and that earlier reports that it may not exist were probably inaccurate. The careful selection of exposed and control groups for analysis strengthens the observed association between vibration syndrome and the occupational use of pneumatic chipping hammers and grinding tools. In the foundry populations studied the vibration syndrome was severe, with short latencies and high prevalences of the advanced stages. The shipyard population did not display this pattern. This difference can be attributed to variations in work practices but the more important factor seems to be the effect of incentive work schedules. Comparisons of groups of hourly and incentive workers from the shipyard and within foundry populations consistently demonstrated that incentive work was associated with increased severity of vibration syndrome. Excessive vibration levels were measured on chipping and grinding tools. Of the factors studied, reduction of throttle level decreased the vibration levels measured on chipping hammers. For grinders, the working condition of the tool affected the measured vibration acceleration levels. Grinders receiving average to poor maintenance showed higher vibration levels. The results of objective clinical testing did not yield tests with diagnostic properties. To date, the clinical judgment of the physician remains the primary focus of the diagnosis of vibration syndrome. A number of actions can be taken to prevent vibration syndrome. Preplacement medical examinations can identify workers predisposed to or experiencing Raynaud's phenomenon or disease. Informing employees and employers about the signs, symptoms, and consequences of vibration syndrome can encourage workers to report the condition to their physicians promptly. Engineering approaches to preventing vibration syndrome include increased quality control on castings to reduce finishing

  18. Computation of water hammer protection of modernized pumping station

    NASA Astrophysics Data System (ADS)

    Himr, Daniel

    2014-03-01

    Pumping station supplies water for irrigation. Maximal capacity 2 × 1.2m3·s-1 became insufficient, thus it was upgraded to 2 × 2m3·s-1. Paper is focused on design of protection against water hammer in case of sudden pumps trip. Numerical simulation of the most dangerous case (when pumps are giving the maximal flow rate) showed that existing air vessels were not able to protect the system and it would be necessary to add new vessels. Special care was paid to influence of their connection to the main pipeline, because the resistance of the connection has a significant impact on the scale of pressure pulsations. Finally, the pump trip was performed to verify if the system worked correctly. The test showed that pressure pulsations are lower (better) than computation predicted. This discrepancy was further analysed.

  19. [Pseudo-Bartter syndrome--2 cases].

    PubMed

    Jóźwiak, Lucyna; Jaroszyński, Andrzej; Baranowicz-Gaszczyk, Iwona; Borowicz, Ewa; Ksiazek, Andrzej

    2010-01-01

    Bartter syndrome represents the group of renal disturbances characterized by hypokaliemia and metabolic alkalosis. Some diseases could display hypokalemic metabolic alkalosis without primary tubular dysfunction. These disorders are called pseudo-Bartter syndrome. In this paper we present 2 cases of pseudo-Bartter syndrome related among to other things to overuse of diuretic drugs.

  20. [Gorlin-Goltz syndrome--a case report].

    PubMed

    Debski, Tomasz; Jethon, Józef

    2010-06-01

    The Gorlin-Goltz syndrome (GGS) (the nevoid basal cell carcinoma syndrome-NBCCS) is an autosomal dominant syndrome caused by mutations found on chromosome 9. The syndrome is characterized by increased predisposition to develop a basal cell carcinoma and associated with multiorgan anomalies. To present a case of GGS and explain modern standards of care for patients with this syndrome. Authors report the case of a 36-year-old patient who was admitted to the Plastic Surgery Clinic due to numerous basal cell carcinomas. Previously patient underwent an orthopaedic, neurologic, dermatologic, stomatologic and surgery treatment due to particular anomalies which characterize this syndrome. Comprehensive interview and broadening of the diagnostics enabled to diagnose GGS and to introduce the appropriate treatment. GGS is a multidisciplinary problem and widespread knowledge of this syndrome could accelerate the diagnosis process. Early diagnosis of GGS allows to introduce the secondary prophylaxis and to apply the appropriate treatment to slow the progress of the syndrome.

  1. Rare case of nephrotic syndrome: Schimke syndrome.

    PubMed

    Pedrosa, Anna Kelly Krislane de Vasconcelos; Torres, Luiz Fernando Oliveira; Silva, Ana Corina Brainer Amorim da; Dantas, Adrianna Barros Leal; Zuntini, Káthia Liliane da Cunha Ribeiro; Aguiar, Lia Cordeiro Bastos

    2016-01-01

    Schimke syndrome corresponds to dysplasia of bone and immunity, associated with progressive renal disease secondary to nephrotic syndrome cortico-resistant, with possible other abnormalities such as hypothyroidism and blond marrow aplasia. It is a rare genetic disorder, with few reports in the literature. The most frequent renal involvement is nephrotic syndrome with focal segmental glomerulosclerosis and progressive renal failure. The objective of this study was to report a case of Schimke syndrome, diagnostic investigation and management of the case. Resumo A síndrome Schimke corresponde à displasia imuno-óssea, associada à doença renal progressiva secundária à síndrome nefrótica córtico-resistente, podendo haver outras anormalidades como hipotireoidismo e aplasia de medula óssea. Trata-se de uma patologia genética rara, com poucos relatos na literatura. O acometimento renal mais frequente é uma síndrome nefrótica por glomeruloesclerose segmentar e focal e falência renal progressiva. O objetivo deste estudo foi relatar um caso de síndrome de Schimke, investigação diagnóstica e condução do caso.

  2. Muffling Hammer Blows In A Workshop

    NASA Technical Reports Server (NTRS)

    Thiele, Alfred W.; Gilbert, Jeffrey L.; Gutow, David A.

    1994-01-01

    Sound-deadening bags placed on hammered workpieces. Useful in many workshop situations. Fabricated easily and inexpensively. Bags filled with particles of sand, metal shot, plastic, or glass, then sewn or molded shut. Tailored to fit special configurations of some workpieces. Devices used to deaden print rollers and to reduce vibrations in main-injector inlet manifold of rocket engine.

  3. Auto-Gopher: A Wire-Line Rotary-Hammer Ultrasonic Drill

    NASA Technical Reports Server (NTRS)

    Badescu, Mircea; Sherrit, Stewart; Bao, Xiaogi; Bar-Cohen, Yoseph; Chen, Beck

    2011-01-01

    Developing technologies that would enable NASA to sample rock, soil, and ice by coring, drilling or abrading at a significant depth is of great importance for a large number of in-situ exploration missions as well as for earth applications. Proven techniques to sample Mars subsurface will be critical for future NASA astrobiology missions that will search for records of past and present life on the planet, as well as, the search for water and other resources. A deep corer, called Auto-Gopher, is currently being developed as a joint effort of the JPL's NDEAA laboratory and Honeybee Robotics Corp. The Auto-Gopher is a wire-line rotary-hammer drill that combines rock breaking by hammering using an ultrasonic actuator and cuttings removal by rotating a fluted bit. The hammering mechanism is based on the Ultrasonic/Sonic Drill/Corer (USDC) that has been developed as an adaptable tool for many of drilling and coring applications. The USDC uses an intermediate free-flying mass to transform the high frequency vibrations of the horn tip into a sonic hammering of a drill bit. The USDC concept was used in a previous task to develop an Ultrasonic/Sonic Ice Gopher. The lessons learned from testing the ice gopher were implemented into the design of the Auto-Gopher by inducing a rotary motion onto the fluted coring bit. A wire-line version of such a system would allow penetration of significant depth without a large increase in mass. A laboratory version of the corer was developed in the NDEAA lab to determine the design and drive parameters of the integrated system. The design configuration lab version of the design and fabrication and preliminary testing results are presented in this paper

  4. Enlargement of basilar artery aneurysms following balloon occlusion--"water-hammer effect". Report of two cases.

    PubMed

    Kwan, E S; Heilman, C B; Shucart, W A; Klucznik, R P

    1991-12-01

    Two patients with distal basilar aneurysms were treated with intra-aneurysmal balloon occlusion. After apparently successful therapy, follow-up angiograms demonstrated aneurysm enlargement with balloon migration distally in the sac. Geometric mismatch between the base of the balloons and the aneurysm neck together with transmitted pulsation through the 2-hydroxyl-ethylmethacrylate (HEMA)-filled balloon directly contributed to aneurysm enlargement. In this report, the authors discuss the problems of progressive aneurysm enlargement due to a "water-hammer effect" and the possibility of hemorrhage following subtotal occlusion.

  5. [Two cases of Costello syndrome].

    PubMed

    Masuyama, Tatsuo; Matsuo, Muneaki; Kuno, Tateo; Kitsuki, Kyoko; Kan, Yuka; Ishii, Kiyohisa; Ohtani, Yoshinobu

    2003-01-01

    We report two unrelated cases of Costello syndrome, presenting with poor postnatal growth, mild mental retardation, poor feeding, curly hair, coarse characteristic face, loose skin, hypotonia, and cardiac involvement. Nasal papilloma and acanthosis nigricans were the most characteristic features of this syndrome. Both cases had atrial fibrilation from infancy to early childhood. One patient had hypertonia in the lower extremities and pes equinovarus, while the other had hypotonia and pes planovalgus.

  6. [Bilateral "crocodile tears syndrome" associated with Melkersson-Rosenthal syndrome--case report].

    PubMed

    Owecki, Michał K; Kapelusiak-Pielok, Magdalena; Kowal, Piotr; Kozubski, Wojciech

    2006-01-01

    We present a rare case of bilateral crocodile tears syndrome (CTS) in the course of Melkersson-Rosenthal syndrome. Melkersson-Rosenthal syndrome is characterised by a triad of recurrent orofacial swelling, relapsing facial paralysis, and fissured tongue. The classic triad is infrequent and oligosymptomatic variants are seen more frequently. CTS is a rare complication of facial nerve paralysis characterised by inappropriate lacrimation on the side of the palsy in response to salivary stimuli. It results from aberrant reinnervation of the lacrimal gland by salivary parasympathetic fibres. The therapeutic approach for an acute bout of Melkersson-Rosenthal syndrome consists mainly of steroid administration. CTS management is composed of anticholinergic drugs and surgical procedures. Botulin toxin injection into the lacrimal gland is the most modern therapeutic option. In the case presented CTS developed in a 50-year-old man after 5 incidents of facial palsy due to Melkersson-Rosenthal syndrome. The case deserves attention due to the rarity of the observed symptoms and signs.

  7. [Occupational carpal tunnel syndrome: 27 cases].

    PubMed

    Slimane, Neila Ben; Elleuch, Mohamed; Gharbi, Ezzedine; Babay, Habib; Hamdoun, Moncef

    2010-09-01

    Carpal tunnel syndrome is the most frequent of tunnel syndromes in the field of the professional sphere. It is related to repetitive movements of flexion-extension of the wrist and fingers or to a support on the heel of the hands. To determine the posts in a risk and to specify the modalities of guaranteed reimbursement of professional carpal tunnel syndrome. A retrospective and descriptive study of 27 medical files of employees indemnified for professional carpal tunnel syndrome registered in the medical control services of the social security office in charge of medical insurance of Tunis and Sousse during a period of 10 years (1995-2004). There were 24 women and 3 men with the average age of 40 years all occupying posts in a risk. Their average time of service is 15 years. Tow-thirds of them work in the clothing and textile industry. The attack is bilateral in 13 cases. Nightly acroparaesthesia rules the clinical rate (44.44% of cases). Motor disorders are noted in the quarter of cases. The electromyogram had confirmed diagnosis in all of cases. The previous state study put in evidence the antecedent of carpal tunnel syndrome in 5 cases and diabetes in one case. Twenty-one patients had profit of permanent partial incapacity with a rate varying from 3 to 25%. Five had got a transfer of working place and one stayed in the same post with a half-time work. The professional origin of carpal tunnel syndrome must be called up in front of an activity in a risk. The reparation is done according to picture 82 of occupational diseases.

  8. Astronaut David Scott watching hammer and feather fall to lunar surface

    NASA Technical Reports Server (NTRS)

    1971-01-01

    Astronaut David R. Scott, Apollo 15 commander, watches a geological hammer and a feather hit the lunar surface simultaneously in a test of Galileo's law of motion concerning falling bodies, as seen in this color reproduction taken from a transmission made by the RCA color television camera mounted on the Lunar Roving Vehicle. Scott released the hammer from his right hand and the feather from his left at the same instant. This experiment occured toward the end of the third and final lunar surface extravehicular activity.

  9. 21 CFR 890.1450 - Powered reflex hammer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Powered reflex hammer. 890.1450 Section 890.1450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1450 Powered reflex...

  10. 21 CFR 890.1450 - Powered reflex hammer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Powered reflex hammer. 890.1450 Section 890.1450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1450 Powered reflex...

  11. 21 CFR 890.1450 - Powered reflex hammer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Powered reflex hammer. 890.1450 Section 890.1450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1450 Powered reflex...

  12. 21 CFR 890.1450 - Powered reflex hammer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Powered reflex hammer. 890.1450 Section 890.1450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1450 Powered reflex...

  13. 21 CFR 890.1450 - Powered reflex hammer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Powered reflex hammer. 890.1450 Section 890.1450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1450 Powered reflex...

  14. Solenoid hammer valve developed for quick-opening requirements

    NASA Technical Reports Server (NTRS)

    Wrench, E. H.

    1967-01-01

    Quick-opening lightweight solenoid hammer valve requires a low amount of electrical energy to open, and closes by the restoring action of the mechanical springs. This design should be applicable to many quick-opening requirements in fluid systems.

  15. Development and validation of a method to directly measure the cable force during the hammer throw.

    PubMed

    Brice, Sara M; Ness, Kevin F; Rosemond, Doug; Lyons, Keith; Davis, Mark

    2008-05-01

    The development of cable force during hammer-throw turns is crucial to the throw distance. In this paper, we present a method that is capable of measuring cable force in real time and, as it does not interfere with technique, it is capable of providing immediate feedback to coaches and athletes during training. A strain gauge was mounted on the wires of three hammers to measure the tension in the wire and an elite male hammer thrower executed three throws with each hammer. The output from the gauges was recorded by a data logger positioned on the lower back of the thrower. The throws were captured by three high-speed video cameras and the three-dimensional position of the hammer's head was determined by digitizing the images manually. The five best throws were analysed. The force acting on the hammer's head was calculated from Newton's second law of motion and this was compared with the force measured via the strain gauge. Qualitatively the time dependence of the two forces was essentially the same, although the measured force showed more detail in the troughs of the force-time curves. Quantitatively the average difference between the measured and calculated forces over the five throws was 76 N, which corresponds to a difference of 3.8% for a cable force of 2000 N.

  16. Identification of characteristic frequencies of damaged railway tracks using field hammer test measurements

    NASA Astrophysics Data System (ADS)

    Oregui, M.; Li, Z.; Dollevoet, R.

    2015-03-01

    In this paper, the feasibility of the Frequency Response Function (FRF)-based statistical method to identify the characteristic frequencies of railway track defects is studied. The method compares a damaged track state to a healthy state based on non-destructive field hammer test measurements. First, a study is carried out to investigate the repeatability of hammer tests in railway tracks. By changing the excitation and measurement locations it is shown that the variability introduced by the test process is negligible. Second, following the concepts of control charts employed in process monitoring, a method to define an approximate healthy state is introduced by using hammer test measurements at locations without visual damage. Then, the feasibility study includes an investigation into squats (i.e. a major type of rail surface defect) of varying severity. The identified frequency ranges related to squats agree with those found in an extensively validated vehicle-borne detection system. Therefore, the FRF-based statistical method in combination with the non-destructive hammer test measurements has the potential to be employed to identify the characteristic frequencies of damaged conditions in railway tracks in the frequency range of 300-3000 Hz.

  17. Potential improvement of Schmidt-hammer exposure-age dating (SHD) of moraines in the Southern Alps, New Zealand, by application of the new electronic Schmidt-hammer (SilverSchmidt)

    NASA Astrophysics Data System (ADS)

    Winkler, Stefan; Corbett, David

    2014-05-01

    The Southern Alps of New Zealand are among the few key study sites for investigating Holocene glacier chronologies in the mid-latitudinal Southern Hemisphere. Their characteristic highly dynamic geomorphological process systems prove, however, to be a considerable challenge for all attempts to date and palaeoclimatologically interpret the existing Holocene moraines record. As a multi-proxy approach combining 10Be terrestrial cosmogenic nuclide dating (TCND) with Schmidt-hammer testing, the recently developed Schmidt-hammer exposure-age dating (SHD) has already shown its potential in this study area (cf. Winkler 2005, 2009, 2013). An electronic Schmidt-hammer (named SilverSchmidt) was introduced by the manufacturer of the original mechanical Schmidt-hammer (Proceq SA) a few years ago. It offers, in particular, facilities for much easier data processing and constitutes a major improvement and potential replacement for the mechanical Schmidt-hammer. However, its different approach to the measurement of surface hardness - based on Q-(velocity) values instead of R-(rebound) values - is a potential drawback. This difference effectively means that measurements from the two instruments are not easily interconvertible and, hence, that the instruments cannot be used interchangeably without previous comparative tests of both instruments under field conditions. Both instruments used in this comparative study were N-type models with identical impact energy of 2.207 Nm for the plunger. To compare both instruments and explore interconvertibility, parallel measurements were performed on a selected number of boulders (10 boulders per site with 5 impacts each, at least 2 sites per moraine) on moraines of homogeneous lithology but different established ages covering the entire Holocene and the Late Glacial. All moraines are located east of the Main Divide of the Southern Alps at Mueller Glacier, Tasman Glacier, and in the outer Tasman River Valley. All paired samples (n = 50) were

  18. Water hammer prediction and control: the Green's function method

    NASA Astrophysics Data System (ADS)

    Xuan, Li-Jun; Mao, Feng; Wu, Jie-Zhi

    2012-04-01

    By Green's function method we show that the water hammer (WH) can be analytically predicted for both laminar and turbulent flows (for the latter, with an eddy viscosity depending solely on the space coordinates), and thus its hazardous effect can be rationally controlled and minimized. To this end, we generalize a laminar water hammer equation of Wang et al. (J. Hydrodynamics, B2, 51, 1995) to include arbitrary initial condition and variable viscosity, and obtain its solution by Green's function method. The predicted characteristic WH behaviors by the solutions are in excellent agreement with both direct numerical simulation of the original governing equations and, by adjusting the eddy viscosity coefficient, experimentally measured turbulent flow data. Optimal WH control principle is thereby constructed and demonstrated.

  19. [3M syndrome: case history].

    PubMed

    Fehlow, P

    2006-01-01

    This case report shall draw attention to a still little known syndrome of primordial nanism. It is important for the differential diagnosis on the genetic counselling, specially with regard to the Silver-Russell syndrome. A striking mentally retarded (I. Q. 54) 9-year-old boy with primordial proportionate short stature exhibited characteristic features of the 3M syndrome (MMM): pseudohydrocephalic dolichocephalia, short neck with protruding muscles, transversal furrow in the lower thorax, muscular hypotonia with joint laxity - "falling hands", radiographic manifestations included the tall vertebral bodies and gracile long bones. Furthermore there was a dent temporal at the left. But this feature is found on many other syndromes with nanosomia frontotemporal, less frequent the low position of the navel on these patients. The karyotype was normal, the case apparently sporadic. MMM can be differentiated from other types of nanosomia by clinical criterias; a molecular genetic proof is not yet possible.

  20. 36. SOUTHWEST TO BELTPOWERED CIRCA 1900 DROP HAMMER IN NORTHEASTERN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    36. SOUTHWEST TO BELT-POWERED CIRCA 1900 DROP HAMMER IN NORTHEASTERN QUADRANT OF FACTORY OPPOSITE FROM THE BLACKSMITH SHOP AREA. THIS MACHINE WAS USED TO SHAPE THE STEEL VANE HINGE PART AFTER IT WAS HEATED IN THE FORGE IN THE ADJACENT BLACKSMITH SHOP AREA. USE OF THE ROTATING POWER OF THE PULLEY AT THE TO MADE LIFTING THE HAMMER COMPARATIVELY QUICK AND EASY. AROUND THE MACHINE ARE WHEEL PARTS FOR ELI WINDMILLS. AT THE LEFT FOREGROUND IS A CIRCA 1900 FOUR-SPINDLE PRODUCTION DRILL PRESS WHICH WAS RELOCATED TO THIS AREA APPARENTLY AFTER THE END OF WINDMILL MANUFACTURE. - Kregel Windmill Company Factory, 1416 Central Avenue, Nebraska City, Otoe County, NE

  1. The Hammer Award is presented to KSC and 45th Space Wing.

    NASA Technical Reports Server (NTRS)

    1999-01-01

    At a special presentation in the IMAX 2 Theater in the Kennedy Space Center Visitor Complex, KSC and 45th Space Wing employees share the honors as recipients of the Hammer Award. The Hammer Award is Vice President Al Gore's special recognition of teams of federal employees who have made significant contributions in support of the principles of the National Partnership for Reinventing Government. Morley Winograd, director of the National Partnership for Reinventing Government, presented the award to Ed Gormel and Chris Fairey, co-chairs of the Joint Base Operations and Support Contract (J-BOSC) Source Evaluation Board (SEB. This Hammer Award acknowledges the accomplishments of a joint NASA and Air Force team that established the J-BOSC SEB. The team developed and implemented the acquisition strategy for establishing a single set of base operations and support service requirements for KSC, Cape Canaveral Air Station and Patrick Air Force Base.

  2. Air distribution system with the discharge action in the working cavity of downhole air hammer drills

    NASA Astrophysics Data System (ADS)

    Timonin, VV; Alekseev, SE; Kokoulin, DI; Kubanychbek, B.

    2018-03-01

    It is proposed to carry out pre-mine methane drainage using underground degassing holes made by downhole air hammer drills. The features of downhole air drills are described. The downhole air drill layout with the simple-shape striking part is presented with its pluses and minuses. The researchers point at available options to eliminate the shortcomings. The improved layout of the downhole air hammer drill is suggested. The paper ends with the test data on the prototype air hammer drill, its characteristics and trial drilling results.

  3. The Hammer Award is presented to KSC and 45th Space Wing.

    NASA Technical Reports Server (NTRS)

    1999-01-01

    KSC's Director of Public Affairs Joe Gordon (left) applauds as Ed Gormel and Chris Fairey are named recipients of the Hammer Award at a special presentation in the IMAX 2 Theater in the Kennedy Space Center Visitor Complex. Presenting the award is Morley Winograd (at the podium), director of the National Partnership for Reinventing Government. The Hammer Award is Vice President Al Gore's special recognition of teams of federal employees who have made significant contributions in support of the principles of the National Partnership for Reinventing Government. This Hammer Award acknowledges the accomplishments of a joint NASA and Air Force team that established the Joint Base Operations and Support Contract (J-BOSC) Source Evaluation Board (SEB). Gormel and Fairey are co-chairs of the SEB. The team developed and implemented the acquisition strategy for establishing a single set of base operations and support service requirements for KSC, Cape Canaveral Air Station and Patrick Air Force Base.

  4. The Hammer Award is presented to KSC and 45th Space Wing.

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Commander of the Air Force Space Command, General Richard B. Myers (left) joins Ed Gormel (center) and Commander of the 45th Space Wing Brig. Gen. F. Randall Starbuck (right) after the presentation of the Hammer Award. The Hammer Award is Vice President Al Gore's special recognition of teams of federal employees who have made significant contributions in support of the principles of the National Partnership for Reinventing Government. Morley Winograd, director of the National Partnership for Reinventing Government, presented the award to the Joint Base Operations and Support Contract (J-BOSC) Source Evaluation Board (SEB). Gormel is a co-chair of the SEB. This Hammer Award acknowledges the accomplishments of a joint NASA and Air Force team that established the J-BOSC SEB. The team developed and implemented the acquisition strategy for establishing a single set of base operations and support service requirements for KSC, Cape Canaveral Air Station and Patrick Air Force Base.

  5. [Jerusalem syndrome - a case report].

    PubMed

    Poleszczyk, Anna; Swiecicki, Łukasz

    2013-01-01

    The aim of the paper was to present the case of a patient who developed acute psychotic symptoms on her visit to Jerusalem. The analysis of the clinical case and medical history. The presented 62-year-old women with a history of previous psychiatric disorder arrived with her husband to Jerusalem as a part of organised touristic group. She developed acute psychotic reaction through some stages characteristic for the third type of Jerusalem syndrome. Symptoms resolved completely soon after returning to Poland and admission to the hospital where an antipsychotic treatment was performed. Despite the rare occurrence of this phenomenon, it is worth noting that we can divide Jerusalem syndrome into three types depending on its clinical course, patient's history of previous psychiatric disorders and this division has some clinical implications. This syndrome can be also considered in the context of some factors connected with travelling in general which may be responsible for psychiatric disturbances occurring among travelers. The course of psychiatric disturbances in the presented patient resembled the third type of Jerusalem syndrome despite her past psychiatric history and probably travelling caused her decompensations. In clinical practice we have to remember that in case of the patients with a known psychiatric history, clinical evaluation may be useful before travelling. In previously healthy patients developing the third type of the Jerusalem syndrome early intervention and separation from Jerusalem and its holy places and their contact with family are crucial for soon recovery.

  6. Pressure and wall shear stress in blood hammer - Analytical theory.

    PubMed

    Mei, Chiang C; Jing, Haixiao

    2016-10-01

    We describe an analytical theory of blood hammer in a long and stiffened artery due to sudden blockage. Based on the model of a viscous fluid in laminar flow, we derive explicit expressions of oscillatory pressure and wall shear stress. To examine the effects on local plaque formation we also allow the blood vessel radius to be slightly nonuniform. Without resorting to discrete computation, the asymptotic method of multiple scales is utilized to deal with the sharp contrast of time scales. The effects of plaque and blocking time on blood pressure and wall shear stress are studied. The theory is validated by comparison with existing water hammer experiments. Copyright © 2016. Published by Elsevier Inc.

  7. Swyer-James syndrome associated with Noonan syndrome: report of a case.

    PubMed

    Lin, Y M; Huang, W L; Hwang, J J; Ko, Y L; Lien, W P

    1995-12-01

    A 28-year-old man with Noonan syndrome associated with unilateral hyperlucent lung is reported. He had the typical craniofacial appearance and short stature of Noonan syndrome; he had mild mental retardation, atrophic testis, mild funnel chest and kyphosis. cardiovascular abnormalities included asymmetric hypertrophic cardiomyopathy and a significantly different caliber of the left and right pulmonary arteries. The unilateral hyperlucent lung was shown to result from acquired nondestructive emphysema caused by nonvalvular obstruction of the bronchi (Swyer-James syndrome or Macleod's syndrome). To the authors' knowledge, this is the first reported case of Noonan syndrome associated with Swyer-James syndrome.

  8. Mirror Syndrome assocciated with Patau Syndrome: A Case Report.

    PubMed

    Pais, Ana Sofia; Areia, Ana Luísa Fialho Amaral de; Franco, Sofia Margarida Perienes; Fonseca, Etelvina Morais Ferreira; Moura, José Paulo Achando Silva

    2018-05-16

    Mirror syndrome is an unusual pathological condition in which maternal edema in pregnancy is seen in association with severe fetal and/or placental hydrops. The disease can be life-threatening for both the mother and the fetus. The pathogenesis is poorly understood, and may be confused with preeclampsia, even though distinguishing features can be identified. We report a rare case of mirror syndrome with maternal pulmonary edema associated with fetal hydrops due to Patau syndrome. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

  9. Lemierre syndrome: two cases and a review.

    PubMed

    Syed, Mohammed Iqbal; Baring, David; Addidle, Michael; Murray, Craig; Adams, Calum

    2007-09-01

    Lemierre syndrome is usually caused by an acute oropharyngeal infection in previously healthy young adults, resulting in thrombophlebitis of the internal jugular vein, leading to metastatic septic embolization and bacteraemia. The usual organism is Fusobacterium necrophorum. Lemierre syndrome, not so long ago labeled as the "forgotten disease," is on the rise. Today with increasing antibiotic-resistant organisms, and decreasing awareness of the syndrome, subsequent re-emergence of this "forgotten disease" is becoming more common in clinical settings. Lemierre syndrome has significant morbidity. Cranial nerve complications associated with the condition have been increasingly diagnosed in the last few years. Looking back at literature on Lemierre syndrome, there have been review articles in medical and microbiology journals but rarely in otolaryngology journals. By presenting our cases we demonstrate the diverse presentations and severity of the illness. A review of the literature and a case report on two cases seen in our institution in the last year are presented. Each of these had varied presentations and neurologic complications-one developed 9th to 12th cranial nerve palsies and Horner syndrome, which have not been described in previous literature, and the other developed polyneuropathy and a frontal lobe infarct among other multisystem complications. Diagnosis of Lemierre syndrome is not always straightforward as clinical features are variable and blood cultures are often negative. Awareness of the syndrome and a high degree of suspicion are needed.

  10. Application of air hammer drilling technology in igneous rocks of Junggar basin

    NASA Astrophysics Data System (ADS)

    Zhao, Hongshan; Feng, Guangtong; Yu, Haiye

    2018-03-01

    There were many technical problems such as serious well deviation, low penetration rate and long drilling cycle in igneous rocks because of its hardness, strong abrasive and poor drillability, which severely influenced the exploration and development process of Junggar basin. Through analyzing the difficulties of gas drilling with roller bits in Well HS 2, conducting the mechanics experiments about igneous rock, and deeply describing the rock-breaking mechanism of air hammer drilling and its adaptability in igneous rocks, air hammer drilling can realize deviation control and fast drilling in igneous rocks of piedmont zone and avoid the wear and fatigue fracture of drilling strings due to its characteristics of low WOB, low RPM and high frequency impact. Through firstly used in igneous rocks of Well HS 201, compared with gas drilling with cone bit, the average penetration rate and one-trip footage of air hammer drilling respectively increased by more than 2.45 times and 6.42 times while the well deviation was always controlled less than 2 degrees. Two records for Block HS were set up such as the fastest penetration rate of 14.29m/h in Φ444.5mm well hole and the highest one-trip footage of 470.62m in Φ311.2mm well hole. So air hammer drilling was an effective way to realize optimal and fast drilling in the igneous rock formation of Junggar basin.

  11. Computerized Hammer Sounding Interpretation for Concrete Assessment with Online Machine Learning.

    PubMed

    Ye, Jiaxing; Kobayashi, Takumi; Iwata, Masaya; Tsuda, Hiroshi; Murakawa, Masahiro

    2018-03-09

    Developing efficient Artificial Intelligence (AI)-enabled systems to substitute the human role in non-destructive testing is an emerging topic of considerable interest. In this study, we propose a novel hammering response analysis system using online machine learning, which aims at achieving near-human performance in assessment of concrete structures. Current computerized hammer sounding systems commonly employ lab-scale data to validate the models. In practice, however, the response signal patterns can be far more complicated due to varying geometric shapes and materials of structures. To deal with a large variety of unseen data, we propose a sequential treatment for response characterization. More specifically, the proposed system can adaptively update itself to approach human performance in hammering sounding data interpretation. To this end, a two-stage framework has been introduced, including feature extraction and the model updating scheme. Various state-of-the-art online learning algorithms have been reviewed and evaluated for the task. To conduct experimental validation, we collected 10,940 response instances from multiple inspection sites; each sample was annotated by human experts with healthy/defective condition labels. The results demonstrated that the proposed scheme achieved favorable assessment accuracy with high efficiency and low computation load.

  12. Crouzon's Syndrome: A Case Report

    PubMed Central

    Jyothsna, M; Ahmed, Syed Basheer; Lakshmi, K Sree

    2013-01-01

    ABSTRACT Crouzon's syndrome (CS) is a rare autosomal dominant condition with multiple mutations of the fibroblast growth factor receptor (FGFR2) gene, which accounts for 4.8% of all cases of craniosynostosis. It is characterized by premature closure of cranial sutures, cranial deformities, midface hypoplasia, relative mandibular prognathism, hypertelorism, proptosis, strabismus and short upper lip, crowding of teeth, pseudocleft or sometimes cleft palate and other associated abnormalities. The CS can vary in severity from mild presentation to severe forms involving multiple cranial sutures. We report a case of CS in 11-year-old boy. How to cite this article: Kumar GR, Jyothsna M, Ahmed SB, Lakshmi KS, Crouzon's Syndrome: A Case Report. Int J Clin Pediatr Dent 2013;6(1):33-37. PMID:25206185

  13. Crouzon's Syndrome: A Case Report.

    PubMed

    Kumar, G Ravi; Jyothsna, M; Ahmed, Syed Basheer; Lakshmi, K Sree

    2013-01-01

    Crouzon's syndrome (CS) is a rare autosomal dominant condition with multiple mutations of the fibroblast growth factor receptor (FGFR2) gene, which accounts for 4.8% of all cases of craniosynostosis. It is characterized by premature closure of cranial sutures, cranial deformities, midface hypoplasia, relative mandibular prognathism, hypertelorism, proptosis, strabismus and short upper lip, crowding of teeth, pseudocleft or sometimes cleft palate and other associated abnormalities. The CS can vary in severity from mild presentation to severe forms involving multiple cranial sutures. We report a case of CS in 11-year-old boy. How to cite this article: Kumar GR, Jyothsna M, Ahmed SB, Lakshmi KS, Crouzon's Syndrome: A Case Report. Int J Clin Pediatr Dent 2013;6(1):33-37.

  14. Gingival fibromatosis with hypertrichosis syndrome: Case series of rare syndrome.

    PubMed

    Balaji, Preetha; Balaji, S M

    2017-01-01

    Gingival fibromatosis with hypertrichosis syndrome is an extremely rare genetic condition characterized by profound overgrowth of hair and gums, as well as other variable features. Gingival fibromatosis is characterized by a large increase in the gingival dimension which extends above the dental crowns, covering them partially or completely. They were found to have a genetic origin, may also occur in isolation or be part of a syndrome, or acquired origin, due to specific drugs administered systemically. Congenital generalized hypertrichosis is a heterogeneous group of diseases with continuing excessive growth of terminal hair without androgenic stimulation. It has informally been called werewolf syndrome because the appearance is similar to that of a werewolf. Various syndromes have been associated with these features such as epilepsy, mental retardation, cardiomegaly, or osteochondrodysplasia. As so far very few cases have been reported in literature, we are reporting a series of three cases with management of the same. The excess gingival tissues, in these cases, were removed by conventional gingivectomy under general anesthesia. The postoperative result was uneventful and the patient's appearance improved significantly. Good esthetic result was achieved to allow patient to practice oral hygiene measures. Though this is not a serious condition clinically, psychosocial trauma cannot be neglected owing to the cosmetic disfigurement it produces.

  15. "Syndrome in syndrome": Wernicke syndrome due to afferent loop syndrome. Case report and review of the literature.

    PubMed

    D'Abbicco, D; Praino, S; Amoruso, M; Notarnicola, A; Margari, A

    2011-01-01

    Wernicke syndrome is a rare neurological pathology due to a deficit in vitamin B1. The syndrome is common among alcohol abusers, patients with malignant tumor or gastrointestinal diseases, those who undergo hemodialysis or long-term peritoneal dialysis, pregnant women with hyperemesis, women who breast-feed, patients with hyperthyroidism or anorexia nervosa or gastric or jejunal-ileal bypass surgery for obesity, patients submitted to gastric surgery or prolonged total parenteral nutrition or prolonged intravenous therapy. We report a case of Wernicke syndrome due to afferent loop syndrome characterized by incoercible vomiting.

  16. Water hammer caused by closure of turbine safety spherical valves

    NASA Astrophysics Data System (ADS)

    Karadžić, U.; Bergant, A.; Vukoslavčević, P.

    2010-08-01

    This paper investigates water hammer effects caused by closure of spherical valves against the discharge. During the first phase of modernisation of Perućica high-head hydropower plant (HPP), Montenegro, safety spherical valves (inlet turbine valves) have been refurbished on the first two Pelton turbine units. The valve closure is controlled by the valve actuator (hydraulic servomotor). Because the torque acting on the valve body is dependent on flow conditions the valve closing time may vary significantly for different flow velocities (passive valve). For the passive valve the torques acting on the valve body should be considered in the valve model. The valve closing time results from numerical simulation. On the contrary, for the active valve the valve closing time is assumed prior to simulation. The spherical valve boundary condition is incorporated into the method of characteristics (MOC) algorithm. The staggered (diamond) grid in applying the MOC is used in this paper. The passive valve boundary condition is described by the water hammer equations, the valve equation that relates discharge to pressure head drop and the dynamic equation of the valve body motion (torque equation). The active valve boundary condition is described by the first two equations, respectively. Standard quasi-steady friction model is used for estimating friction losses in plant's tunnel and penstocks. Numerical results using both the active and the passive spherical valve models are compared with results of measurements. It has been found that the influence of flow conditions on the spherical valve closing time is minor for the cases considered. Computed and measured results agree reasonably well.

  17. Gorlin-goltz syndrome: a rare case.

    PubMed

    Ganguly, Satyaki; Jaykar, Kranti C; Kumar, Rajesh; Jha, Abhijeet Kumar; Banerjee, P K

    2015-01-01

    Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome is characterized by multiple basocellular epitheliomas, keratocysts in the jaws, bifid ribs, palmar and/or plantar pits and ectopic calcifications of the falx cerebri. We describe a case of Gorlin-Goltz syndrome illustrating the importance of a thorough examination including the examination of palms and soles and detailed investigations in a patient having lesions suggestive of basal cell carcinoma and multiple naevi.

  18. Percussive Augmenter of Rotary Drills for Operating as a Rotary-Hammer Drill

    NASA Technical Reports Server (NTRS)

    Aldrich, Jack Barron (Inventor); Bar-Cohen, Yoseph (Inventor); Sherrit, Stewart (Inventor); Badescu, Mircea (Inventor); Bao, Xiaoqi (Inventor); Scott, James Samson (Inventor)

    2014-01-01

    A percussive augmenter bit includes a connection shaft for mounting the bit onto a rotary drill. In a first modality, an actuator percussively drives the bit, and an electric slip-ring provides power to the actuator while being rotated by the drill. Hammering action from the actuator and rotation from the drill are applied directly to material being drilled. In a second modality, a percussive augmenter includes an actuator that operates as a hammering mechanism that drives a free mass into the bit creating stress pulses that fracture material that is in contact with the bit.

  19. 31. FORGE, ANVIL, POWER FORGE HAMMER (FRONT TO BACK), AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    31. FORGE, ANVIL, POWER FORGE HAMMER (FRONT TO BACK), AND DOORWAY INTO MAIN SHOP-LOOKING SOUTHWEST. - W. A. Young & Sons Foundry & Machine Shop, On Water Street along Monongahela River, Rices Landing, Greene County, PA

  20. Linear or Rotary Actuator Using Electromagnetic Driven Hammer as Prime Mover

    NASA Technical Reports Server (NTRS)

    McMahan, Bert K. (Inventor); Sesler, Joshua J. (Inventor); Paine, Matthew T. (Inventor); McMahan, Mark C. (Inventor); Paine, Jeffrey S. N. (Inventor); Smith, Byron F. (Inventor)

    2018-01-01

    We claim a hammer driven actuator that uses the fast-motion, low-force characteristics of an electro-magnetic or similar prime mover to develop kinetic energy that can be transformed via a friction interface to produce a higher-force, lower-speed linear or rotary actuator by using a hammering process to produce a series of individual steps. Such a system can be implemented using a voice-coil, electro-mechanical solenoid or similar prime mover. Where a typical actuator provides limited range of motion or low force, the range of motion of a linear or rotary impact driven motor can be configured to provide large displacements which are not limited by the characteristic dimensions of the prime mover.

  1. Effect of bit wear on hammer drill handle vibration and productivity.

    PubMed

    Antonucci, Andrea; Barr, Alan; Martin, Bernard; Rempel, David

    2017-08-01

    The use of large electric hammer drills exposes construction workers to high levels of hand vibration that may lead to hand-arm vibration syndrome and other musculoskeletal disorders. The aim of this laboratory study was to investigate the effect of bit wear on drill handle vibration and drilling productivity (e.g., drilling time per hole). A laboratory test bench system was used with an 8.3 kg electric hammer drill and 1.9 cm concrete bit (a typical drill and bit used in commercial construction). The system automatically advanced the active drill into aged concrete block under feed force control to a depth of 7.6 cm while handle vibration was measured according to ISO standards (ISO 5349 and 28927). Bits were worn to 4 levels by consecutive hole drilling to 4 cumulative drilling depths: 0, 1,900, 5,700, and 7,600 cm. Z-axis handle vibration increased significantly (p<0.05) from 4.8 to 5.1 m/s 2 (ISO weighted) and from 42.7-47.6 m/s 2 (unweighted) when comparing a new bit to a bit worn to 1,900 cm of cumulative drilling depth. Handle vibration did not increase further with bits worn more than 1900 cm of cumulative drilling depth. Neither x- nor y-axis handle vibration was effected by bit wear. The time to drill a hole increased by 58% for the bit with 5,700 cm of cumulative drilling depth compared to a new bit. Bit wear led to a small but significant increase in both ISO weighted and unweighted z-axis handle vibration. Perhaps more important, bit wear had a large effect on productivity. The effect on productivity will influence a worker's allowable daily drilling time if exposure to drill handle vibration is near the ACGIH Threshold Limit Value. [1] Construction contractors should implement a bit replacement program based on these findings.

  2. [Clinical study of 12 cases with obstetric mirror syndrome].

    PubMed

    Wu, Lin-lin; Wang, Chen-hong; Li, Zhi-quan

    2012-03-01

    To discuss the clinical features, management, pregnancy outcome and prognosis of obstetric mirror syndrome. The clinical data of 12 cases with obstetric mirror syndrome at Shenzhen Maternity and Child Healthcare Hospital from April 2008 to December 2010 were collected to retrospectively analyze the clinical features, management, pregnancy outcome and prognosis. (1) ETIOLOGY: 12 cases with obstetric mirror syndrome included 9 cases of Bart's hydrops fetalis, 2 cases with fetal complicated congenital cardiac anomalies, and 1 case of unknown etiology. (2) Gestational age at diagnosis and at delivery: gestational age at diagnosis ranged from 28 to 36 weeks [mean (31.5 ± 4.7) weeks], and gestational age at delivery ranged from 28(+3) to 38 weeks [mean (32.9 ± 2.9) weeks]. There were no significant differences between the gestational age at diagnosis and at delivery in consistence with severe preeclampsia group and mild preeclampsia group [(31.8 ± 2.3) weeks vs. (30.9 ± 7.2) weeks, (32.5 ± 2.3) weeks vs. (33.5 ± 3.9) weeks, P > 0.05]. (3) The patients with obstetric mirror syndrome can present a preeclampsia-like syndrome: maternal extremity edema in 12 cases, headache and visual disturbance in 1 case, proteinuria in 11 cases, elevated blood pressure in 5 cases, elevated uric acid in 9 cases, hypoproteinemia in 12 cases, elevated creatinine in 3 case, elevated liver enzyme in 1 case, thrombocytopenia in 2 cases. The major complications included 1 case of HELLP syndrome, acute pulmonary edema, placental abruption, amnionic fluid embolism, DIC respectively, 3 cases of acute kidney failure and 6 cases of postpartum hemorrhage. (4) Sonographic findings: 1) Hydrops fetalis: fetal ultrasound revealed pleural fluid, fetal ascites, skin edema, scalp edema, encephalocolele enlargement, hydropericardium and increased cardio-chest ratio. 2) Placenta megaly: the placental pathological examination revealed edematous and large in 12 cases. Placental thickness was beyond 4 cm in

  3. A Rare Case of Acute Coronary Syndrome in a Patient With Turner Syndrome.

    PubMed

    Kemaloglu, Tugba; Ozer, Nihat; Fikri Yapici, Mehmet

    2016-05-01

    In Turner syndrome, cardiovascular complications are the most important causes of early mortality. Congenital cardiovascular abnormalities are found in approximately one third of Turner syndrome patients. Developments in diagnosis and treatment have decreased the rate of mortality related to these abnormalities. In recent years, many papers have mentioned that coronary artery disease developing at early ages in patients with Turner syndrome causes sudden deaths. The patient, a 27-year-old female was admitted to the emergency room with chest pain at rest. She was diagnosed with Turner Syndrome in her teenage years due to amenorrhea. Patients with ECG changes and cardiac enzyme elevations were treated with acute coronary syndrome. The young woman with Turner Syndrome have several risk factors for early Coronary Artery Disease development. In such cases, dramatic results like sudden death or heart attack at an early age may occur in cases of insufficient follow-up and treatment.

  4. Anesthetic management of Costello syndrome: a case report.

    PubMed

    Williams, Christol

    2014-04-01

    Costello syndrome is a rare genetic disorder with an estimated 300 medical cases worldwide. Typical features that characterize this syndrome include short stature, macrocephaly, developmental delay, loose skin folds, distinctive coarse facial features, and multiorgan system anomalies. The following case report discusses the anesthetic management for a 3-year-old boy undergoing general anesthesia for a scheduled dental restoration, hydrocelectomy, inguinal hernia repair, and bilateral myringotomy with placement of pressure equalization tubes. A scarcity of literature for the anesthetic management of Costello syndrome (also known as faciocutaneoskeletal syndrome) exists. Utilizing an overview of the pertinent literature, clinical practice recommendations are suggested for the anesthetic implications of managing a pediatric patient with this rare syndrome.

  5. Gorlin-Goltz Syndrome: A Rare Case

    PubMed Central

    Ganguly, Satyaki; Jaykar, Kranti C; Kumar, Rajesh; Jha, Abhijeet Kumar; Banerjee, PK

    2015-01-01

    Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome is characterized by multiple basocellular epitheliomas, keratocysts in the jaws, bifid ribs, palmar and/or plantar pits and ectopic calcifications of the falx cerebri. We describe a case of Gorlin-Goltz syndrome illustrating the importance of a thorough examination including the examination of palms and soles and detailed investigations in a patient having lesions suggestive of basal cell carcinoma and multiple naevi. PMID:25814758

  6. Reversible hemispheric hypoperfusion in two cases of SMART syndrome.

    PubMed

    Wai, Karmen; Balabanski, Anna; Chia, Nicholas; Kleinig, Timothy

    2017-09-01

    Stroke-like migraine attacks after radiation therapy (SMART) syndrome manifests as prolonged episodes of cortical dysfunction, years after cranial irradiation. We present two cases demonstrating reversible hemispheric hypoperfusion. Case 1 presented with left hemispheric symptoms following previous similar episodes. CT perfusion (CTP) demonstrated reversible hemispheric hypoperfusion; subsequent investigations were consistent with SMART syndrome. Case 2 presented following the third episode of a hemispheric syndrome with near-identical CTP abnormalities. L-arginine was administered with rapid reversal of clinical and CTP abnormalities. We conclude that SMART syndrome may demonstrate significant hypoperfusion on hyperacute CTP without subsequent infarction. Impaired cerebrovascular autoregulation probably contributes to cortical dysfunction in SMART syndrome. L-arginine warrants investigation as a potential treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Churg-strauss syndrome: a case report.

    PubMed

    Zhdan, Vyacheslav М; Kitura, Yevdokiia М; Kitura, Oksana Ye; Babanina, Maryna Yu; Tkachenko, Maksym V; Lebid, Volodymyr G

    A clinical case of Churg-Strauss syndrome has been reported on the 53-year-old female patient Ts. with bronchial asthma and allergic rhinitis. The main clinical signs and syndromes depending on the stage of the disease are presented, as well as therapeutic treatment of patients with this disease.

  8. The Hammer Award is presented to KSC and 45th Space Wing.

    NASA Technical Reports Server (NTRS)

    1999-01-01

    At a special presentation of the Hammer Award in the IMAX 2 Theater in the Kennedy Space Center Visitor Complex, former Apollo astronauts Neil Armstrong (left) and Edwin 'Buzz' Aldrin (second from right) applauded the recipients, Kennedy Space Center and the 45th Space Wing. The Hammer Award is Vice President Al Gore's special recognition of teams of federal employees who have made significant contributions in support of the principles of the National Partnership for Reinventing Government. This Hammer Award acknowledges the accomplishments of a joint NASA and Air Force team that established the Joint Base Operations and Support Contract (J-BOSC) Source Evaluation Board (SEB). Ed Gormel and Chris Fairey, co-chairs of the SEB, accepted the awards for the SEB. The team developed and implemented the acquisition strategy for establishing a single set of base operations and support service requirements for KSC, Cape Canaveral Air Station and Patrick Air Force Base. Armstrong and Aldrin were at KSC to attend a banquet and other activities for the 30th anniversary of the Apollo 11 mission, which landed the first man on the moon.

  9. Vestibular dysfunction in Turner syndrome: a case report.

    PubMed

    Baxter, Michael; Agrawal, Yuri

    2014-02-01

    Turner syndrome is a well-known cause of sensorineural hearing loss, and the lack of estrogen has been implicated in cochlear dysfunction. It has never been associated with vestibular dysfunction. We report a case of a patient with Turner syndrome who was found to have bilateral vestibular dysfunction based on video-oculography (VOG) testing. A single patient with a history of Turner syndrome who was found to have significant bilateral vestibular dysfunction. After noticing a deficit in the vestibulo-ocular reflexes on qualitative horizontal head impulse examination, the patient underwent VOG testing. VOG testing quantatively measures angular vestibulo-ocular reflex (AVOR) gain in the horizontal semicircular canal plane. AVOR gain represents the eye movement response to a head movement; in normal individuals the eye movement is fully compensatory and gain values are close to unity. VOG results showed AVOR gains of 0.29 and 0.36 on the right and left sides, respectively. We have presented a case of a woman with Turner syndrome with asymptomatic vestibular dysfunction demonstrated with VOG testing. Although there is a documented relationship between Turner syndrome and sensorineural hearing loss, there are no previous studies or case reports linking Turner syndrome and vestibular dysfunction. Additional research and added vigilance in monitoring Turner syndrome patients may be warranted.

  10. Two extraordinarily severe cases of Treacher Collins syndrome.

    PubMed

    Bauer, Mislen; Saldarriaga, Wilmar; Wolfe, S Anthony; Beckwith, J Bruce; Frias, Jaime L; Cohen, M Michael

    2013-03-01

    Here, we report two extraordinarily severe cases of Teacher Collins syndrome. Initially, amniotic bands and plical fold disruption were considered, but downslanting eyes made us consider severe Treacher Collins syndrome. A TCOF1 mutation in exon 24 was identified in Patient 1 (c.4355_4356ins14, resulting in p.1456Thrfs*18). Patient 2, who expired on day 4, is so similar to Patient 1 that severe Treacher Collins syndrome may be inferred in this instance. Neither the TCOF1 mutation nor the well-known variability in the expression in affected families with Treacher Collins syndrome (∼40% of reported cases) can explain the severity of these cases; otherwise, we would be aware of such cases within families from time to time. We are unaware of any recent sporadic cases (∼60% of reported cases) exactly like ours either with a single exception in the case reported by Writzl et al. [2008] with a TCOF1 mutation. The case described by Otto in 1841 is spectacular. We propose several hypotheses to be considered in explaining this developmental amplification, including some promoter effect on the gene, some position effect on the gene, a polymorphism elsewhere in the gene, a point mutation elsewhere in the gene, a polymorphism in another gene, or a point mutation in another gene, such as POLR1C (which maps to 6p21.1) or POLR1D (which maps to13q12.2). We also review the etiology and pathogenesis of Treacher Collins syndrome, and discuss several other severe cases from the past. Copyright © 2013 Wiley Periodicals, Inc.

  11. Conundrums in neurology: diagnosing serotonin syndrome - a meta-analysis of cases.

    PubMed

    Werneke, Ursula; Jamshidi, Fariba; Taylor, David M; Ott, Michael

    2016-07-12

    Serotonin syndrome is a toxic state, caused by serotonin (5HT) excess in the central nervous system. Serotonin syndrome's main feature is neuro-muscular hyperexcitability, which in many cases is mild but in some cases can become life-threatening. The diagnosis of serotonin syndrome remains challenging since it can only be made on clinical grounds. Three diagnostic criteria systems, Sternbach, Radomski and Hunter classifications, are available. Here we test the validity of four assumptions that have become widely accepted: (1) The Hunter classification performs clinically better than the Sternbach and Radomski criteria; (2) in contrast to neuroleptic malignant syndrome, the onset of serotonin syndrome is usually rapid; (3) hyperthermia is a hallmark of severe serotonin syndrome; and (4) serotonin syndrome can readily be distinguished from neuroleptic malignant syndrome on clinical grounds and on the basis of medication history. Systematic review and meta-analysis of all cases of serotonin syndrome and toxicity published between 2004 and 2014, using PubMed and Web of Science. Two of the four assumptions (1 and 2) are based on only one published study each and have not been independently validated. There is little agreement between current criteria systems for the diagnosis of serotonin syndrome. Although frequently thought to be the gold standard for the diagnosis of the serotonin syndrome, the Hunter criteria did not perform better than the Sternbach and Radomski criteria. Not all cases seem to be of rapid onset and only relatively few cases may present with hyperthermia. The 0 differential diagnosis between serotonin syndrome and neuroleptic malignant syndrome is not always clear-cut. Our findings challenge four commonly made assumptions about serotonin syndrome. We propose our meta-analysis of cases (MAC) method as a new way to systematically pool and interpret anecdotal but important clinical information concerning uncommon or emergent phenomena that cannot be

  12. Case report of a patient with 'one-and-a-half plus syndrome: nine syndrome'.

    PubMed

    Uthman, Muhammad; Kamran, Mehreen

    2018-01-01

    This case talks about 'One-and-a-half plus syndrome', a clinical syndrome affecting binocular vision and facial nerve. One-and-a-half plus syndrome is a less known clinical syndrome which constitutes of a conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other direction. Despite the known association between ischemia, autoimmune disorders, multiple sclerosis, with mono neuritis multiplex resulting in extra ocular movement disorder, one-and-a-half plus syndrome is rarely considered in the differential diagnosis of eye ball movement disorders, as many clinicians are not able to diagnose such a case as ' the eyes don't see what the mind doesn't know'. Our report aims to raise awareness about connective tissue disorders presenting as neuro-ophthalmological syndrome, as early recognition can accelerate diagnosis and decrease the morbidity.

  13. Non-syndromic odontogenic keratocysts: A rare case report

    PubMed Central

    Kurdekar, Raghavendra S.; Prakash, Jeevan; Rana, A. S.; Kalra, Puneet

    2013-01-01

    Odontogenic keratocysts are very well documented in the literature. Multiple odontogenic keratocysts (OKCs) are one of the most frequent features of nevoid basal cell carcinoma syndrome (NBCCS). It is linked with mutation in the PTCH gene (human homolog of the drosophila segment polarity gene, “patched”,). Partial expression of the gene may result in occurrence of only multiple recurring OKC without any associated systemic findings. A rare case of multiple odontogenic keratocysts unassociated with any syndrome is reported, so as to add to the growing number of such cases in the literature. The possibility of this case being a partial expression of the Gorlin-Goltz syndrome is discussed. PMID:24163561

  14. [Case of posterior reversible encephalopathy syndrome caused by Fisher syndrome].

    PubMed

    Yokoi, Katsunori; Ando, Tetsuo; Kawakami, Osamu

    2018-01-26

    This report presents a case of a 71-year-old woman with Fisher syndrome who had posterior reversible encephalopathy syndrome (PRES) before the initiation of intravenous immunoglobulin (IVIg) treatment. She had symptoms of common cold 2 weeks before the onset of PRES. On the day of the onset, she began to stagger while walking. On day 2, she developed hypertension, vision impairment, and limb weakness and was admitted to the hospital. On day 3, she was provided steroid pulse therapy. On day 4, she developed convulsions and right imperfection single paralysis and was transferred to the our hospital. During the transfer, the patient was conscious. Her blood pressure was high at 198/107 mmHg. She had mild weakness in her limbs and face, light perception in both eyes, dilation of both pupils, total external ophthalmoplegia, no tendon reflexes, and limb and trunk ataxia. We diagnosed PRES because of the high signal intensities observed on T 2 -weighted MRI on both sides of the parietal and occipital lobes. We also diagnosed Fisher syndrome because of a positive anti-GQ1b immunoglobulin G antibody test and albuminocytologic dissociation in the cerebrospinal fluid. PRES showed prompt improvement with antihypertensive therapy, whereas Fisher syndrome slowly improved over a course of 2 months. This case is the first report of PRES without IVIg suggesting that Fisher syndrome induces hypertension and causes PRES.

  15. Anophthalmia-Waardenburg syndrome: a report of three cases.

    PubMed

    Suyugül, Z; Seven, M; Hacihanefioğlu, S; Kartal, A; Suyugül, N; Cenani, A

    1996-04-24

    We report on 2 Turkish families with children who had bilateral anophthalmia, upper and lower limb abnormalities, mental retardation and consanguineous parents. We have evaluated the 2 cases in the first family and the only case in the second as anophthalmia-Waardenburg syndrome. This is an extremely rare autosomal recessive syndrome.

  16. [Pearson syndrome. Case report].

    PubMed

    Cammarata-Scalisi, Francisco; López-Gallardo, Ester; Emperador, Sonia; Ruiz-Pesini, Eduardo; Da Silva, Gloria; Camacho, Nolis; Montoya, Julio

    2011-09-01

    Among the etiologies of anemia in the infancy, the mitochondrial cytopathies are infrequent. Pearson syndrome is diagnosed principally during the initial stages of life and it is characterized by refractory sideroblastic anemia with vacuolization of marrow progenitor cells, exocrine pancreatic dysfunction and variable neurologic, hepatic, renal and endocrine failures. We report the case of a 14 month-old girl evaluated by a multicentric study, with clinic and molecular diagnosis of Pearson syndrome, with the 4,977-base pair common deletion of mitochondrial DNA. This entity has been associated to diverse phenotypes within the broad clinical spectrum of mitochondrial disease.

  17. Munchausen syndrome by proxy: a case report.

    PubMed

    Lieder, Holly S; Irving, Sharon Y; Mauricio, Rizalina; Graf, Jeanine M

    2005-01-01

    Munchausen syndrome by proxy is difficult to diagnose unless healthcare providers are astute to its clinical features and management. A case is presented to educate nurses and advanced practice nurses, of the nursing, medical, legal, and social complexities associated with Munchausen syndrome by proxy. This article also provides a brief review of the definition of Munchausen syndrome by proxy, its epidemiology, common features of the perpetrator, implications for healthcare personnel, and the legal and international ramifications of Munchausen syndrome by proxy.

  18. 5. VIEW OF 20TON STEAMPOWERED FORGE HAMMER Manufactured by Chambersburg ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. VIEW OF 20-TON STEAM-POWERED FORGE HAMMER Manufactured by Chambersburg Engineering Company, Chambersburg, Pennsylvania - Juniata Shops, Blacksmith Shop No. 1, East of Fourth Avenue at Second Street, Altoona, Blair County, PA

  19. [Usher syndrome: about a case].

    PubMed

    Daoudi, Chama; Boutimzine, Noureddine; Haouzi, Samia El; Lezrek, Omar; Tachfouti, Samira; Lezrek, Mounir; Laghmari, Mina; Daoudi, Rajae

    2017-01-01

    Usher syndrome is a genetic disease resulting in double sensory deprivation (auditory and visual) called deafblindness. We report the case of a 50-year old patient, born to consanguineous parents, presenting with congenital deafness associated with normal vestibular function and pigmentary retinopathy responsible for decreased bilateral visual acuity occurred at the age of 16 years. This association composes Usher syndrome type 2, a rare autosomal recessive disorder. Cataract surgery allowed visual acuity improvement in this patient.

  20. Case Of Iatrogenic Cushing's Syndrome By Topical Triamcinolone.

    PubMed

    Zil-E-Ali, Ahsan; Janjua, Omer Hanif; Latif, Aiza; Aadil, Muhammad

    2018-01-01

    Cushing's syndrome is a collection of signs and symptoms due to hypercortisolism. Prolong use of topical steroid may cause this syndrome and suppression of hypothalamic and pituitary function, however such events are more common with oral and parenteral route. There are very few cases of Cushing's syndrome with a topical application amongst which triamcinolone is the rarest drug. We report a case of 11-year-old boy is presented who developed Cushing's disease by topical application. The child had body rashes for which the caregiver consulted a local quack, a topical cream of triamcinolone was prescribed. After application for three months, the patient became obese and developed a moon-like face. A thorough biochemical workup and diagnostic test for Cushing's disease was done to confirm. The following case report a dramatic example of development of the syndrome from chronic topical application of the least potent corticosteroid.

  1. The hammer QSD-quick stop device for high speed machining and rubbing

    NASA Technical Reports Server (NTRS)

    Black, J. T.; James, C. R.

    1980-01-01

    A quick stop device (QSD) was designed for use in orthogonal machining and rubbing experiments. QSD's are used to obtain chip root samples that are representative of the deformation taking place during dynamic (actual) cutting conditions. These 'frozen' specimens are helpful in examining the plastic deformation that occurs in the regions of compression and shear which form the chip; the secondary shear at the tool-chip interface; and the nose ploughing/flank rubbing action which operates on the newly machined surface. The Hammer QSD employs a shear pin mechanism, broken by a flying hammer, which is traveling at the same velocity as the workpiece. The device has been successfully tested up to 6000 sfpm (30.48 m/sec).

  2. The Hammer Award is presented to KSC and 45th Space Wing.

    NASA Technical Reports Server (NTRS)

    1999-01-01

    At a special presentation in the IMAX 2 Theater in the Kennedy Space Center Visitor Complex, the Hammer Award is presented to Kennedy Space Center and the 45th Space Wing. Among the attendees in the audience are (center) Center Director Roy D. Bridges Jr., flanked by (at left) Commander of the 45th Space Wing Brig. Gen. F. Randall Starbuck and (at right) Commander of the Air Force Space Command General Richard B. Myers. Standing second from right is NASA Administrator Daniel S. Goldin. At the far right is Morley Winograd, director of the National Partnership for Reinventing Government, who presented the award. The Hammer Award is Vice President Al Gore's special recognition of teams of federal employees who have made significant contributions in support of the principles of the National Partnership for Reinventing Government. This Hammer Award acknowledges the accomplishments of a joint NASA and Air Force team that established the Joint Base Operations and Support Contract (J- BOSC) Source Evaluation Board (SEB). Ed Gormel and Chris Fairey, co-chairs of the SEB, accepted the awards for the SEB. The team developed and implemented the acquisition strategy for establishing a single set of base operations and support service requirements for KSC, Cape Canaveral Air Station and Patrick Air Force Base.

  3. Asperger syndrome related suicidal behavior: two case studies.

    PubMed

    Kocourkova, Jana; Dudova, Iva; Koutek, Jiri

    2013-01-01

    Asperger syndrome hinders adaptation to developmental challenges during childhood and adolescence, particularly with regard to interpersonal relationships. Individuals with Asperger syndrome display lack of empathy and limited ability to understand social and emotional exchanges with other people. Individuals with Asperger syndrome are significantly exposed to the risk of suicidal behavior, especially during adolescence. The authors describe cases of suicidal behavior in two adolescent boys with Asperger syndrome.

  4. Cavitation luminescence in a water hammer: Upscaling sonoluminescence

    NASA Astrophysics Data System (ADS)

    Su, C.-K.; Camara, C.; Kappus, B.; Putterman, S. J.

    2003-06-01

    Oscillatory acceleration and deceleration of a column of water leads to a pipe hammer as well as cavitation. With a small amount of xenon gas dissolved in the water, we can detect a stream of predominantly ultraviolet subnanosecond flashes of light which are attributed to collapsing bubbles. The observed emission can exceed 108 photons for a single collapse and has a peak power over 0.4 W.

  5. Sliding pressure control valve for pneumatic hammer drill

    DOEpatents

    Polsky, Yarom [Albuquerque, NM

    2011-08-30

    A pneumatic device control apparatus and method comprising a ported valve slidably fitted over a feed tube of the pneumatic device, and using a compliant biasing device to constrain motion of the valve to provide asymmetric timing for extended pressurization of a power chamber and reduced pressurization of a return chamber of the pneumatic device. The pneumatic device can be a pneumatic hammer drill.

  6. Seckel syndrome: a report of a case.

    PubMed

    Ramalingam, K; Kaliyamurthy, S D; Govindarajan, M; Swathi, S

    2012-01-01

    Seckel syndrome, first defined by Seckel in 1960, is a rare (incidence 1:10,000), genetically heterogeneous autosomal recessive disorder presenting at birth. This syndrome is characterized by a proportionate dwarfism of prenatal onset, a severe microcephaly with a "bird-headed" like appearance (beaked nose, receding forehead, prominent eyes, and micrognathia), and mental retardation. The significance of dental alterations in this syndrome resides in the defect, hypoplastic enamel, being limited to the primary dentition; in most instances the second primary molar tooth is not affected. A case of the Seckel syndrome is presented.

  7. Sjogren’s syndrome: a case report

    NASA Astrophysics Data System (ADS)

    Sunata, A.; Marpaung, B.

    2018-03-01

    The incidence of Sjogren’s Syndrome was estimated 4 in 100.000 of these cases with the prevalence is 0.2% to 2.7% of the population. Predominant sex female/male ratio is approximately 10:1 with peak incidence is in the fourth and fifth decade. A 29-year-old woman had dry eyes and recurrent sensation of sand in the eyes for two years. Schimmer’s test was positive ≤5mm in 5 minutes both, and the autoantibodies SSA and SSB were positive. Without history head or neck radiation and the result of laboratory examination hepatitis C and HIV negative. Until now there is no satisfying therapy for Sjogren Syndrome, only supportive specific to symptomatic can be treated. We reported a case of Sjogren Syndrome with dry eyes symptom, polyathralgia, and fatigue. Muscarinic agonist pilocarpine 5mg PO qid and hydroxychloroquine were given.

  8. Usher's syndrome--case report.

    PubMed

    Kwiecień, Sława; Sulak, Robert; Szaflik, Jerzy

    2008-01-01

    The aim of this study is to present a case of coincidence of sensorineural hearing loss with chronic recurrent bilateral cystoid macular oedema in a 32-year-old woman, who was admitted to the clinic for deterioration of visual acuity of four months' duration. The patient gave a history of hearing loss for 29 years. Visual field examination disclosed peripheral ring scotoma. Electrophysiological examination was performed: pattern visual evoked response was within normal limits and electroretinogram displayed diminished both photopic and scotopic response. As ophthalmoscopy demonstrated no pigment in the fundus of the eye, the findings were consisted with diagnosis of retinitis pigmentosis sine pigmento. The presence of loss of hearing indicated the necessity of performing the genetic examination for Usher's syndrome. In order to establish a final diagnosis of Usher's syndrome genetic examination must be performed, but family history is relevant. Early investigation for Usher's syndrome in children with sensorineural hearing impairment is of a great significance. The patient may develop symptoms of retinitis pigmentosa in second or even third decade of his life. The necessity of thorough investigation for detecting other systemic abnormalities should be emphasized. There is no effective treatment of this syndrome. A child with Usher's syndrome requires a comprehensive care of different medical specialties. Psychological, educational and sociological attitude is also of a great importance in the child development.

  9. Reversible Cerebral Vasoconstriction Syndrome in Pediatrics: A Case Series and Review.

    PubMed

    Coffino, Samantha W; Fryer, Robert H

    2017-06-01

    Reversible cerebral vasoconstriction syndrome is a transient vasculopathy associated with severe headaches and stroke. In most cases of reversible cerebral vasoconstriction syndrome, there is a precipitating event or trigger, such as pregnancy, serotonin agonist treatment or illicit drug use. The authors present 2 pediatric cases of reversible cerebral vasoconstriction syndrome and review the previous 11 pediatric cases in the literature. In many instances, the clinical and radiographic features are similar in both pediatric and adult cases. In the pediatric group, reported potential triggers include trauma (1/13), exercise (2/13), water to the face (3/13), hypertension (3/13), and medication or substance use (4/13). One surprising difference is that 11 out of 13 pediatric patients with reversible cerebral vasoconstriction syndrome are male while most cases in adults are female. Many of the pediatric patients with reversible cerebral vasoconstriction syndrome were treated with a calcium channel blocker and the overall outcome of pediatric reversible cerebral vasoconstriction syndrome was good, with most patients experiencing a full recovery.

  10. [Corneal lesions in Kindler syndrome: a case report].

    PubMed

    Chéour, M; Mazlout, H; Ben Jalel, W; Brour, J; Baroudi, B; Kraiem, A

    2012-01-01

    Kindler syndrome is a rare autosomal recessive genodermatosis belonging to the class of bullous poikiloderma. Corneal lesions are rare. We report a case of ocular lesions in this syndrome. We report the case of a 57-year-old patient followed since childhood in dermatology with the diagnosis of Kindler syndrome. He presented to the ophthalmology department with decreased vision. Ophthalmologic examination showed symblepharon, ectropion in both eyes, and corneal deformation. The role played by the abnormal protein in epithelial integrity suggests that ocular and more particularly corneal involvement is not rare in Kindler syndrome. In fact, it is less known by ophthalmologists and dermatologists are not aware of the ophthalmologic manifestations. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  11. Clinical characteristics of mirror syndrome: a comparison of 10 cases of mirror syndrome with non-mirror syndrome fetal hydrops cases.

    PubMed

    Hirata, Go; Aoki, Shigeru; Sakamaki, Kentaro; Takahashi, Tsuneo; Hirahara, Fumiki; Ishikawa, Hiroshi

    2016-01-01

    To investigate clinical features of mirror syndrome. We retrospectively reviewed 71 cases of fetal hydrops with or without mirror syndrome, and compared with respect to maternal age, the body mass index, the primipara rate, the gestational age at delivery, the timing of fetal hydrops onset, the severity of fetal edema, placental swelling, the laboratory data and the fetal mortality. The data are expressed as the medians. Mirror syndrome developed in 29% (10/35) of the cases with fetal hydrops. In mirror group, the onset time of fetal hydrops was significantly earlier (29 weeks versus 31 weeks, p = 0.011), and the severity of fetal hydrops (fetal edema/biparietal diameter) was significantly higher than non-mirror group (0.23 versus 0.16, p < 0.001). There was significantly higher serum human chorionic gonadotropin (hCG) (453,000 IU/L versus 80,000 IU/L, p < 0.001) and lower hemoglobin (8.9 g/dL versus 10.1 g/dL, p =0.002), hypoalbuminemia (2.3 mg/dL versus 2.7 mg/dL, p = 0.007), hyperuricemia (6.4 mg/dL versus 5.0 mg/dL, p = 0.043) in mirror group. Mirror syndrome is occurred frequently in early and severe fetal hydrops and cause hemodilution and elevation of serum hCG.

  12. Case report: waardenburg syndrome.

    PubMed

    Dumayas, Grace Lea; Capó-Aponte, José E

    2015-03-01

    A case of Waardenburg syndrome type 1 is described and relevant literature is reviewed to raise awareness about this rare syndrome, including the classification of each subtype and the differentiating clinical manifestations. A 44-year-old African-American female presented for a routine evaluation with hearing loss, dystopia canthorum (W index = 2.74), and almost complete gray hair. In addition, she presented with heterochromia irides, different fundus pigmentation between eyes. The patient did not have any upper limbs defect, cranial skeletal abnormalities, or intestinal disorders. Facial abnormalities and a white forelock are prominent features difficult to overlook during a routine ophthalmological examination. A careful medical history in patients with suspected Waardenburg syndrome is important to accurately classify this rare condition and to identify potential systemic implications associated to each subtype. The associated systemic complications can be addressed and managed through referral to the appropriate subspecialties. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  13. Genoa Syndrome and Central Diabetes Insipidus: A Case Report

    PubMed Central

    Şıklar, Zeynep; Erdeve, Şenay Savaş; Berberoğlu, Merih; Deda, Gülhiz; Tıraş, Serap Teber; Fitöz, Suat; Öçal, Gönül

    2010-01-01

    Genoa syndrome was first described by Camera et al in 1993 in two patients with semilobar holoprosencephaly (HPE), craniosynostosis and abnormal small hands with cone−shaped epiphyses and hypoplastic terminal phalanges of fingers (OMIM: 601370). In 2001, Lapunzina et al reported a case of craniosynostosis and HPE associated with several other malformations and suggested that these findings could be attributed to a severe form of Genoa syndrome or to a newly recognized syndrome. Endocrinopathies in association with HPE are frequently reported in the literature. Diabetes insipidus, hypothyroidism, hypocortisolism, and growth hormone deficiency are frequently associated with HPE. We here report a case of semilobar HPE, craniosynostosis and cleft lip/palate, possibly a case of Genoa syndrome, associated with central diabetes insipidus. Conflict of interest:None declared. PMID:21274346

  14. Nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome). Case report.

    PubMed

    Fini, G; Belli, E; Mici, E; Virciglio, P; Moricca, L M; D'Itri, L; Leonardi, A; Malavenda, M S; Krizzuk, D; Merola, R; Maturo, A; Pasta, V

    2013-01-01

    Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome (NBCCS) comprises multiple basal cell carcinomas, keratocysts of the jaw, palmar/plantar pits, spine and rib anomalies, calcifications of the falx cerebri etc. The diagnosis is made according to clinical criteria (Kimonis Criteria) and genetic ones. We studied one family where father and then his sun resulted affected by each syndrome. Gorlin-Goltz syndrome is a rare disease diagnosed according to clinical criteria sometimes difficult to integrate. The family case we presented shows how you can get diagnosis even in older age and after numerous surgeries. Patients should be given special attention and therefore should be monitorized and need multidisciplinary treatments continued in time, even a trivial change of signs and symptoms may be an important indicator of a precipitating event which puts the patient's life under threat.

  15. Nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome). Case report

    PubMed Central

    FINI, G.; BELLI, E.; MICI, E.; VIRCIGLIO, P.; MORICCA, L.M.; D’ITRI, L.; LEONARDI, A.; MALAVENDA, M.S.; KRIZZUK, D.; MEROLA, R.; MATURO, A.; PASTA, V.

    2013-01-01

    Summary: Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome (NBCCS) comprises multiple basal cell carcinomas, keratocysts of the jaw, palmar/plantar pits, spine and rib anomalies, calcifications of the falx cerebri etc. The diagnosis is made according to clinical criteria (Kimonis Criteria) and genetic ones. We studied one family where father and then his sun resulted affected by each syndrome. Gorlin-Goltz syndrome is a rare disease diagnosed according to clinical criteria sometimes difficult to integrate. The family case we presented shows how you can get diagnosis even in older age and after numerous surgeries. Patients should be given special attention and therefore should be monitorized and need multidisciplinary treatments continued in time, even a trivial change of signs and symptoms may be an important indicator of a precipitating event which puts the patient’s life under threat. PMID:23837959

  16. Drug rash, eosinophilia, and systemic symptoms syndrome: Two pediatric cases demonstrating the range of severity in presentation--A case of vancomycin-induced drug hypersensitivity mimicking toxic shock syndrome and a milder case induced by minocycline.

    PubMed

    Vinson, Amy E; Dufort, Elizabeth M; Willis, Matthew D; Eberson, Craig P; Harwell, Joseph I

    2010-07-01

    Drug rash, eosinophilia, and systemic symptoms syndrome is a type of drug hypersensitivity reaction characterized by the clinical triad of skin eruption, fever, and internal organ involvement. Drug rash, eosinophilia, and systemic symptoms syndrome has rarely been reported in association with vancomycin or in the pediatric population. There have only been four pediatric case reports of drug rash, eosinophilia, and systemic symptoms syndrome and three cases of drug rash, eosinophilia, and systemic symptoms syndrome involving vancomycin published in the English literature to date. We describe two pediatric cases of drug rash, eosinophilia, and systemic symptoms syndrome to illustrate the range in severity of presentation. The first case illustrates drug rash, eosinophilia, and systemic symptoms syndrome associated with vancomycin exposure in a 14-yr-old boy with Duchenne muscular dystrophy after posterior spinal fusion, whose clinical presentation was indistinguishable from toxic shock syndrome. The second case illustrates a milder and more typical presentation of drug rash, eosinophilia, and systemic symptoms syndrome in a 14-yr-old boy being treated with minocycline for acne. We also present a review of the literature relevant to this syndrome. : Drug rash, eosinophilia, and systemic symptoms syndrome is relatively unknown among general pediatricians and pediatric intensivists and may potentially become more common with the increasing use of long-term medications in the pediatric population. Our cases demonstrate the importance of an awareness of drug rash, eosinophilia, and systemic symptoms syndrome among general pediatricians and pediatric intensivists because drug rash, eosinophilia, and systemic symptoms syndrome may present in any range of severity, from indolent illness to frank and refractory shock.

  17. Mazabraud's syndrome: case report and literature review

    PubMed Central

    Munksgaard, Peter Svenssen; Salkus, Giedrius; Iyer, Victor V; Fisker, Rune Vincents

    2013-01-01

    Mazabraud's syndrome is a rare disorder characterized by the association of single or multiple intramuscular myxomas with fibrous dysplasia. Here, we present the first case of Mazabraud's syndrome visualized on 18F-FDG PET/CT with histopathological confirmation of the myxoma. Our case demonstrates a slightly increased FDG uptake (SUVmax 2.1) within the myxomas and a moderately to highly increased tracer uptake (SUVmax 7.0) within the fibrous dysplastic lesions. The typical histological appearance of the intramuscular myxoma confirmed the radiological diagnosis. Further, we discuss the imaging findings and the histopathological features of this rare case with a review of the related literature. PMID:24198959

  18. Asperger's syndrome: a case report

    PubMed Central

    Goodman, Carol M.

    1987-01-01

    A case report is presented of an 11-year-old boy who has been diagnosed as having Asperger's syndrome. There follows a review of the clinical features, course, prognosis and management of this condition. PMID:2453672

  19. Williams-Beuren's Syndrome: A Case Report.

    PubMed

    Zamani, Hassan; Babazadeh, Kazem; Fattahi, Saeid; Mokhtari-Esbuie, Farzad

    2012-01-01

    Williams-Beuren syndrome is a rare familial multisystem disorder occurring in 1 per 20,000 live births. It is characterized by congenital heart defects (CHD), skeletal and renal anomalies, cognitive disorder, social personality disorder and dysmorphic facies. We present a case of Williams syndrome that presented to us with heart murmur and cognitive problem. A 5-year-old girl referred to pediatric cardiologist because of heart murmurs. She had a systolic murmur (2-3/6) in right upper sternal border with radiation to right cervical region. She also had a bulge forehead. Angiography showed mild supra valvular aortic stenosis and mild multiple peripheral pulmonary stenosis. Fluorescent in situ hybridization (FISH) was performed and the result was: 46.XX, ish del (7q11.2) (ELN X1) (7q22 X2) ELN deletion compatible with Williams syndrome. Peripheral pulmonary artery stenosis is associated with Noonan syndrome, Alagille syndrome, Cutis laxa, Ehler-Danlos syndrome, and Silver-Russel syndrome. The patient had peripheral pulmonary artery stenosis, but no other signs of these syndromes were present, and also she had a supravalvular aortic stenosis which was not seen in other syndromes except Williams syndrome. Conclusion. According to primary symptoms, paraclinical and clinical finding such as dysmorphic facies, cognitive disorder and congenital heart defect, Williams syndrome was the first diagnosis. We suggest a more attention for evaluating heart murmur in childhood period, especially when the patient has abnormal facial features or mental problem.

  20. Williams-Beuren's Syndrome: A Case Report

    PubMed Central

    Zamani, Hassan; Babazadeh, Kazem; Fattahi, Saeid; Mokhtari-Esbuie, Farzad

    2012-01-01

    Williams-Beuren syndrome is a rare familial multisystem disorder occurring in 1 per 20,000 live births. It is characterized by congenital heart defects (CHD), skeletal and renal anomalies, cognitive disorder, social personality disorder and dysmorphic facies. We present a case of Williams syndrome that presented to us with heart murmur and cognitive problem. A 5-year-old girl referred to pediatric cardiologist because of heart murmurs. She had a systolic murmur (2-3/6) in right upper sternal border with radiation to right cervical region. She also had a bulge forehead. Angiography showed mild supra valvular aortic stenosis and mild multiple peripheral pulmonary stenosis. Fluorescent in situ hybridization (FISH) was performed and the result was: 46.XX, ish del (7q11.2) (ELN X1) (7q22 X2) ELN deletion compatible with Williams syndrome. Peripheral pulmonary artery stenosis is associated with Noonan syndrome, Alagille syndrome, Cutis laxa, Ehler-Danlos syndrome, and Silver-Russel syndrome. The patient had peripheral pulmonary artery stenosis, but no other signs of these syndromes were present, and also she had a supravalvular aortic stenosis which was not seen in other syndromes except Williams syndrome. Conclusion. According to primary symptoms, paraclinical and clinical finding such as dysmorphic facies, cognitive disorder and congenital heart defect, Williams syndrome was the first diagnosis. We suggest a more attention for evaluating heart murmur in childhood period, especially when the patient has abnormal facial features or mental problem. PMID:22927862

  1. Neonatal Marfan syndrome: Report of two cases.

    PubMed

    Jurko, Tomas; Jurko, Alexander; Minarik, Milan; Micieta, Vladimir; Tonhajzerova, Ingrid; Kolarovszka, Hana; Zibolen, Mirko

    2017-07-01

    Marfan syndrome is rarely diagnosed in the neonatal period because of variable expression and age-dependent appearance of clinical signs. The prognosis is usually poor due to high probability of congestive heart failure, mitral and tricuspid regurgitations with suboptimal response to medical therapy and difficulties in surgical management. The authors have studied two cases of Marfan syndrome in the newborn period. Two cases of neonatal Marfan syndrome, one male and one female, were diagnosed by characteristic physical appearance. Both infants had significant cardiovascular abnormalities diagnosed by ultrasonography. Genetic DNA analysis in the second case confirmed the mutations in the fibrillin-1 gene located on chromosome 15q21 which is responsible for the development of Marfan syndrome. The boy died at six weeks of age with signs of rapidly progressive left ventricular failure associated with pneumonia. The second infant was having only mild signs of congestive heart failure and has been treated with beta blockers. At the age of 4 years her symptoms of congestive heart failure had worsened due to progression of mitral and tricuspid insufficiency and development of significant cardiomegaly. Mitral and tricuspid valvuloplasy had to be done at that time. Early diagnosis of Marfan syndrome in the newborn period can allow treatment in the early stages of cardiovascular abnormalities and may improve the prognosis. It also helps to explain to the family the serious health problem of their child.

  2. [Wilkie Syndrome. A case report].

    PubMed

    González Hermosillo-Cornejo, Daniel; Díaz Girón-Gidi, Alejandro; Vélez-Pérez, Francisco Manuel; Lemus-Ramírez, Ramón Ignacio; Andrade Martínez-Garza, Pablo

    Wilkie syndrome, also referred as superior mesenteric artery syndrome, is an unusual cause of a proximal small bowel obstruction. It is characterised by the compression of the duodenum in its third portion due to a narrowing of the space between the superior mesenteric artery and the aorta. Its presentation symptoms are consistent and include the obstruction of the proximal small bowel. However, the physical and laboratory findings are non-specific. Nevertheless, many imaging methods are useful for its diagnosis. The management of this condition varies between observation and surgery, depending on each particular case. The case is presented of a 19 year-old male who began with acute, intense abdominal pain, nausea, vomiting, and diarrhoea. On examination, he had abdominal wall rigidity and hyperesthesia. Imaging studies were requested, revealing a decreased superior mesenteric artery angle, a shortening of the aortic mesenteric distance, and a decrease in the calibre of the third duodenal portion, all findings concomitant with Wilkie syndrome. Conservative treatment was applied and the patient was discharged without complications. Wilkie syndrome continues to be an unknown condition to the general practitioner, and the underdiagnosis of this condition may put a patient at risk of serious complications. A high index of suspicion is required to reach a diagnosis. Early treatment should give a good outcome most of the time. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  3. 'Munchausen syndrome by proxy' presenting as battered child syndrome: a report of two cases.

    PubMed

    Sugandhan, Selvendran; Gupta, Somesh; Khandpur, Sujay; Khanna, Neena; Mehta, Manju; Inna, Prashanth

    2010-06-01

    Child abuse is a major public health crisis and is on the rise. Dermatologists are frequently involved in its evaluation in differentiating abusive injuries from accidental injuries and in excluding pathological conditions that may mimic abuse. Battered child syndrome or physical abuse is not only a common form of child abuse but can also result from a rarer form of child abuse known as Munchausen syndrome by proxy. In this form of abuse, mother, who is the usual perpetrator, induces an illness or abuses the child for her own self-serving psychological needs. We report two cases of battered child syndrome. In both the cases, Psychiatric evaluation was performed on both parents. Observation through one-way mirror was done with the mother and the child alone. Routine hematological and biochemical investigations were done. Diagnosis of Munchausen syndrome by proxy was firmly established in one case and was considered as a possibility in the other. A multidisciplinary team effort is essential in evaluating such cases, and dermatologists should be aware and be well informed about this condition that can be potentially lethal but easily overlooked.

  4. [Toxic-shock syndrome. Three cases (author's transl)].

    PubMed

    Rapin, M; D'Enfert, J; Cabane, J

    1981-06-13

    Several cases of toxic shock syndrome (T.S.S) have been recently reported from the U.S.A. Clinical features of this new syndrome include fever, desquamative scarlatiniform rash, hypotension and involvement of central nervous system, liver, kidney and muscles. More than 90% of cases are women with staphylococcic vaginitis using tampons during menstruations. A toxin produced by staphylococcus aureus is thought to be the causative agent, because the germ has been isolated in local (vaginal, pharyngeal, subcutaneous or other sites) but not systemic (blood, cerebrospinal fluid) cultures. The mortality rate is 3-10%, and relapse can occur. We report the first three french cases of T.S.S.: a 17 year old girl with typical tampon-associated vaginitis, a 36 year old woman with a postoperative peritonitis and a 20 year old man with a popliteal abscess. Staphylococcus aureus of type I or IV was identified at the site of infection in all cases, but never in blood cultures. These three patients recovered with antistaphylococcic antibiotics and supportive therapy, but local treatment of infections seems to have been of utmost importance. These cases suggest that T.S.S. can occur with several staphylococcus serotypes and confirm that this syndrome is not always associated with tampons and vaginitis.

  5. Vasospastic angina and scombroid syndrome: a case report.

    PubMed

    Coppola, G; Caccamo, G; Bacarella, D; Corrado, E; Caruso, M; Cannavò, M G; Assennato, P; Novo, S

    2012-01-01

    Scombroid syndrome is a fish poisoning characterised by the onset of symptoms compatible with a pseudoallergic reaction; it is rarely also responsible of signs and symptoms of acute coronary syndromes, as demonstrated in this case report.

  6. Grinding energy and physical properties of chopped and hammer-milled barley, wheat, oat, and canola straws

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    J.S. Tumuluru; L.G. Tabil; Y. Song

    2014-01-01

    In the present study, specific energy for grinding and physical properties of wheat, canola, oat and barley straw grinds were investigated. The initial moisture content of the straw was about 0.13–0.15 (fraction total mass basis). Particle size reduction experiments were conducted in two stages: (1) a chopper without a screen, and (2) a hammer mill using three screen sizes (19.05, 25.4, and 31.75 mm). The lowest grinding energy (1.96 and 2.91 kWh t-1) was recorded for canola straw using a chopper and hammer mill with 19.05-mm screen size, whereas the highest (3.15 and 8.05 kWh t-1) was recorded for barleymore » and oat straws. The physical properties (geometric mean particle diameter, bulk, tapped and particle density, and porosity) of the chopped and hammer-milled wheat, barley, canola, and oat straw grinds measured were in the range of 0.98–4.22 mm, 36–80 kg m-3, 49–119 kg m-3, 600–1220 kg m-3, and 0.9–0.96, respectively. The average mean particle diameter was highest for the chopped wheat straw (4.22-mm) and lowest for the canola grind (0.98-mm). The canola grinds produced using the hammer mill (19.05-mm screen size) had the highest bulk and tapped density of about 80 and 119 kg m-3; whereas, the wheat and oat grinds had the lowest of about 58 and 88–90 kg m-3. The results indicate that the bulk and tapped densities are inversely proportional to the particle size of the grinds. The flow properties of the grinds calculated are better for chopped straws compared to hammer milled using smaller screen size (19.05 mm).« less

  7. Influence of pin and hammer mill on grinding characteristics, thermal and antioxidant properties of coriander powder.

    PubMed

    Barnwal, P; Singh, K K; Sharma, Alka; Choudhary, A K; Saxena, S N

    2015-12-01

    In present study, influence of grinding (hammer and pin mills) and moisture content (range: 6.4-13.6 % dry basis) on the quality traits of coriander powder were investigated. These include grinding parameters, colour parameters, specific heat, thermal conductivity, thermal diffusivity, glass transition temperature, essential oil, total phenolic content, total flavonoid content and DPPH scavenging (%) of coriander powder. For coriander seed, the geometric properties such as major, medium, minor dimensions, geometric mean diameter, arithmetic mean diameter, sphericity, surface area and volume of coriander seeds increased significantly with increasing moisture (6.4-13.6 % db). For coriander powder, the grinding parameters such as average particle size, volume surface mean diameter and volume mean diameter increased significantly with increasing moisture (6.4-13.6 % db). With the grinding method, the colour attributes of coriander powder such as L-value, a-value, b-value, hue angle and browning index varied significantly. It was observed that the specific heat followed second order polynomial relationship with temperature and moisture whereas thermal conductivity varied linearly with temperature and moisture content. The variation of glass transition temperature with moisture can be best represented in quadratic manner. Total flavonoid content (mg QE/g crude seed extract) and DPPH scavenging % activity of coriander powder is significantly affected by grinding methods. A lower value of specific heat was observed for hammer ground coriander powder as compared to pin mill ground coriander powder. The thermal conductivity of hammer mill ground coriander powder was higher as compared to pin mill ground coriander. It was observed that hammer mill yields more fine coriander powder in comparison to pin mill. The browning index was more in hammer mill ground coriander powder.

  8. PLATEAU IRIS SYNDROME--CASE SERIES.

    PubMed

    Feraru, Crenguta Ioana; Pantalon, Anca Delia; Chiselita, Dorin; Branisteanu, Daniel

    2015-01-01

    Plateau iris is characterized by closing the anterior chamber angle due to a large ciliary body or due to its anterior insertion that alters the position of iris periphery in respect to the trabecular meshwork. There are two aspects that need to be differentiated: plateau iris configuration and plateau iris syndrome. The first describes a situation when the iris root is flat and the anterior chamber is not shallow, the latter refers to a post laser iridotomy condition in which a patent iridotomy has removed the relative pupillary block, but goniscopically confirmed angle closure recurs without central shallowing of the anterior chamber. Isolated plateau iris syndrome is rare compared to plateau iris configuration. We hereby present two case reports of plateau iris syndrome in young patients who came to an ophthalmologic consult by chance.

  9. Hermansky-Pudlak Syndrome: A Case Report

    PubMed Central

    Berber, Ilhami; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Koroglu, Mustafa; Gul, Mehmet; Bentli, Recep

    2014-01-01

    Objective. The aim of this paper is to report the case of a patient diagnosed with Hermansky-Pudlak syndrome, as a result of bleeding diathesis. Clinical Presentation and Intervention. A 23-year-old male presented with recurrent epistaxis and, upon physical examination, was found to be remarkable for albinism and suborbital ecchymosis. The absence of dense bodies in the platelets was demonstrated using electron microscopy. This patient was (slowly) administered one unit of a platelet suspension, and his bleeding decreased considerably. Conclusion. This case shows that Hermansky-Pudlak syndrome should be considered in the differential diagnosis of a patient presenting with bleeding diathesis, when the clinical presentation also includes oculocutaneous albinism and visual problems. PMID:24707413

  10. Refeeding syndrome or refeeding hypophosphatemia: a systematic review of cases.

    PubMed

    Skipper, Annalynn

    2012-02-01

    Nutrition support clinicians refer to the abnormalities in laboratory data and changes in clinical signs and symptoms that follow refeeding of starved or malnourished patients as refeeding syndrome. Theoretical descriptions of refeeding syndrome include a complex and extensive list of changes, such as hypophosphatemia, hypomagnesemia, hypokalemia, hyponatremia, hypocalcemia, hyperglycemia, and vitamin deficiency--all of which are accompanied by clinical signs and symptoms. In practice, clinicians see asymptomatic refeeding hypophosphatemia more often than a full-blown syndrome with multiple laboratory and clinical abnormalities. Confusion results because there is no widely accepted or uniformly applied set of defining characteristics for diagnosing refeeding syndrome. To gain insight into the clinical characteristics of refeeding syndrome described in the literature, a systematic review of reported cases and case series was conducted. Since 2000, 20 authors described 27 cases that contained sufficient data for review. Hypophosphatemia occurred in 26 patients (96%). While 19 patients (71%) experienced at least 1 other laboratory abnormality, only 14 (51%) exhibited a consistent pattern of abnormally low phosphorus and magnesium levels. Seven patients had hypocalcemia (26%), and hyponatremia was reported in 3 patients (11%). There were no reports of hyperglycemia. Mean data reported in case series containing data from 63 patients showed that hypophosphatemia was a consistent finding but that other abnormalities were not consistently identified. Findings suggest that refeeding hypophosphatemia is not accompanied by a consistent pattern of biochemical or clinical abnormalities among case reports or case series of patients reported to have refeeding syndrome.

  11. Gorlin syndrome with bilateral polydactyly: a rare case report.

    PubMed

    Acharya, Sonu; Panda, Swagatika; Singh Dhull, Kanika; Sahoo, Sujit Ranjan; Ray, Prayas

    2013-09-01

    Gorlin's syndrome is a rare disorder transmitted as an autosomal dominant trait. It is characterized by multiple disorders involving multiple systems. We present a case of 11-year-old male child presenting with multiple odontogenic keratocyst to the dental clinic. Retrograde diagnosis of Gorlin-Goltz syndrome was made after clinical and radiological investigation. How to cite this article: Acharya S, Panda S, Dhull KS, Sahoo SR, Ray P. Gorlin Syndrome with Bilateral Polydactyly: A Rare Case Report. Int J Clin Pediatr Dent 2013;6(3):208-212.

  12. Evaluation of the Components of the North Carolina Syndromic Surveillance System Heat Syndrome Case Definition.

    PubMed

    Harduar Morano, Laurel; Waller, Anna E

    To improve heat-related illness surveillance, we evaluated and refined North Carolina's heat syndrome case definition. We analyzed North Carolina emergency department (ED) visits during 2012-2014. We evaluated the current heat syndrome case definition (ie, keywords in chief complaint/triage notes or International Classification of Diseases, Ninth Revision, Clinical Modification [ ICD-9-CM] codes) and additional heat-related inclusion and exclusion keywords. We calculated the positive predictive value and sensitivity of keyword-identified ED visits and manually reviewed ED visits to identify true positives and false positives. The current heat syndrome case definition identified 8928 ED visits; additional inclusion keywords identified another 598 ED visits. Of 4006 keyword-identified ED visits, 3216 (80.3%) were captured by 4 phrases: "heat ex" (n = 1674, 41.8%), "overheat" (n = 646, 16.1%), "too hot" (n = 594, 14.8%), and "heatstroke" (n = 302, 7.5%). Among the 267 ED visits identified by keyword only, a burn diagnosis or the following keywords resulted in a false-positive rate >95%: "burn," "grease," "liquid," "oil," "radiator," "antifreeze," "hot tub," "hot spring," and "sauna." After applying the revised inclusion and exclusion criteria, we identified 9132 heat-related ED visits: 2157 by keyword only, 5493 by ICD-9-CM code only, and 1482 by both (sensitivity = 27.0%, positive predictive value = 40.7%). Cases identified by keywords were strongly correlated with cases identified by ICD-9-CM codes (rho = .94, P < .001). Revising the heat syndrome case definition through the use of additional inclusion and exclusion criteria substantially improved the accuracy of the surveillance system. Other jurisdictions may benefit from refining their heat syndrome case definition.

  13. [Report of a case with Joubert syndrome and literature review].

    PubMed

    Yi, Ya-hui; Li, Gang; Lu, Zhong-lie; Zhou, Jian-sheng; Yao, Zhen-wei; Wang, Peng-fei; Yao, Jin-xiang

    2011-12-01

    To explore the clinical feature, imaging and their diagnostic value for Joubert syndrome (JS). The clinical data, imaging feature, and 31 references from China Biomedical literature database (CBMdise) were reviewed and analyzed. The age of onset of 32 patients including male 20 and female 12 ranged from 3 days to 6 years (mean 2.2 years). All the 32 patients with Joubert syndrome showed "slow growth" and "reduced muscle tension", 26 cases (81.3%) showed "gasp for breath", 26 cases (81.3%) showed "unusual motion of eyeball", 2 cases (6.3%) showed additional fingers (toes), 6 cases (18.8%) showed stretching tongue with agape. The typical imaging features of Joubert syndrome included "molar tooth sign", "midline cleavage" between cerebellar hemispheres and "bat-wing" like fourth ventricle, all the 32 patients with Joubert syndrome showed "midline cleavage", "molar tooth sign" was present in 29 cases (90.1%), and "bat-wing" like fourth ventricle in 30 cases (93.8%). Joubert syndrome is a rare congenital brain malformation. The typical clinical manifestations included "gasp for breath", "reduced tension of muscle", "slow growth" and "unusual motion of eyeball", and at the same time the patients had the following typical imaging features of brain: "molar tooth sign", "midline cleavage" and "bat-wing" like fourth ventricle.

  14. Testing as a Service with HammerCloud

    NASA Astrophysics Data System (ADS)

    Medrano Llamas, Ramón; Barrand, Quentin; Elmsheuser, Johannes; Legger, Federica; Sciacca, Gianfranco; Sciabà, Andrea; van der Ster, Daniel

    2014-06-01

    HammerCloud was designed and born under the needs of the grid community to test the resources and automate operations from a user perspective. The recent developments in the IT space propose a shift to the software defined data centres, in which every layer of the infrastructure can be offered as a service. Testing and monitoring is an integral part of the development, validation and operations of big systems, like the grid. This area is not escaping the paradigm shift and we are starting to perceive as natural the Testing as a Service (TaaS) offerings, which allow testing any infrastructure service, such as the Infrastructure as a Service (IaaS) platforms being deployed in many grid sites, both from the functional and stressing perspectives. This work will review the recent developments in HammerCloud and its evolution to a TaaS conception, in particular its deployment on the Agile Infrastructure platform at CERN and the testing of many IaaS providers across Europe in the context of experiment requirements. The first section will review the architectural changes that a service running in the cloud needs, such an orchestration service or new storage requirements in order to provide functional and stress testing. The second section will review the first tests of infrastructure providers on the perspective of the challenges discovered from the architectural point of view. Finally, the third section will evaluate future requirements of scalability and features to increase testing productivity.

  15. Gorlin-Goltz syndrome: A series of three cases.

    PubMed

    Patankar, Amod P; Kshirsagar, Rajesh A; Dugal, Arun; Mishra, Akshay; Ram, Hari

    2014-01-01

    The Gorlin-Goltz syndrome (GGS) is also known as nevoid basal cell carcinoma syndrome. It is characterized by multiple keratocystic odontogenic tumors (KCOTs) in the jaw, multiple basal cell nevi carcinomas and skeletal abnormities. The syndrome may be diagnosed early by a dentist during the routine radiographic exams in the first decade of life, since the KCOTs are usually one of the first manifestations of the syndrome. This article reports the series of 3 cases, emphasizing its clinical and radiographic manifestations of GGS.

  16. Astronaut David Scott watching hammer and feather fall to lunar surface

    NASA Image and Video Library

    1971-08-02

    S71-43788 (2 Aug. 1971) --- Astronaut David R. Scott, Apollo 15 commander, watches a geological hammer and a feather hit the lunar surface simultaneously in a test of Galileo's law of motion concerning falling bodies, as seen in this color reproduction taken from a transmission made by the RCA color television camera mounted on the Lunar Roving Vehicle (LRV). Scott released the hammer from his right hand and the feather from his left at the same instant. Galileo (1564-1642) was the great Italian astronomer and physicist. This experiment occurred toward the end of the third and final lunar surface extravehicular activity (EVA) by astronauts Scott and James B. Irwin, lunar module pilot. While Scott and Irwin descended in the Lunar Module (LM) to explore the moon, astronaut Alfred M. Worden, command module pilot, remained in the Command and Service Modules (CSM) in lunar orbit.

  17. How to HAMMER home hazardous materials training

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ollero, J.

    1994-10-01

    This article describes HAMMER - the Hazardous Materials Management and Emergency Response Training - program being developed at the Hanford Reservation. The program uses true-to-life props and facilities to simulate emergencies and hazardous conditions. Topics covered include the set-up of the facility and training; the demand for such training; the involvement of the Army Corps of Engineers; the props to be constructed; the educational involvement of Tulane and Xavier Univerisities of Louisiana; temporary facility for the program; partnership with Indian Nations and Stakeholders; and budget plans and constriction. 9 figs.

  18. Gorlin-Goltz syndrome: A rare case report.

    PubMed

    Pol, Chetan A; Ghige, Suvarna K; Kalaskar, Ritesh R; Gosavi, Suchitra R

    2013-10-01

    Gorlin-Goltz syndrome is an uncommon autosomal dominant inherited disorder characterized by numerous basal cell carcinomas, odontogenic keratocysts (OKCs) and musculoskeletal malformations. A rare case of this syndrome observed in a 13-year-old male patient is presented in which multiple OKCs were causing disfigurement of the lower jaw as well as displacement and malocclusion of the teeth. Early diagnosis and treatment of this syndrome is important to reduce the severity of complications including cutaneous and cerebral malignancy and oromaxillofacial deformation and destruction due to jaw cysts.

  19. Gorlin Syndrome with Bilateral Polydactyly: A Rare Case Report

    PubMed Central

    Acharya, Sonu; Panda, Swagatika; Sahoo, Sujit Ranjan; Ray, Prayas

    2013-01-01

    ABSTRACT Gorlin's syndrome is a rare disorder transmitted as an autosomal dominant trait. It is characterized by multiple disorders involving multiple systems. We present a case of 11-year-old male child presenting with multiple odontogenic keratocyst to the dental clinic. Retrograde diagnosis of Gorlin-Goltz syndrome was made after clinical and radiological investigation. How to cite this article: Acharya S, Panda S, Dhull KS, Sahoo SR, Ray P. Gorlin Syndrome with Bilateral Polydactyly: A Rare Case Report. Int J Clin Pediatr Dent 2013;6(3):208-212. PMID:25206225

  20. Fryns anophthalmia-plus syndrome: two rare cases.

    PubMed

    Bozkurt, O; Bidev, D; Sari, F N; Dizdar, E A; Ulu, H O; Uras, N; Oguz, S S; Canpolat, F E; Dilmen, U

    2014-01-01

    Fryns anophthalmia-plus syndrome is a rare syndrome with clinical diversity primarily including anophthalmia/microphthalmia, facial clefts, cleft lip/palate, ear and nasal deformities. Here we present two different cases of APS with anopthalmia/microphthalmia, cleft palate, low set ears, ventriculomegaly and one of which had intestinal non-fixation anomaly not described in the literature before.

  1. Gorlin-Goltz syndrome: A series of three cases

    PubMed Central

    Patankar, Amod P.; Kshirsagar, Rajesh A.; Dugal, Arun; Mishra, Akshay; Ram, Hari

    2014-01-01

    The Gorlin-Goltz syndrome (GGS) is also known as nevoid basal cell carcinoma syndrome. It is characterized by multiple keratocystic odontogenic tumors (KCOTs) in the jaw, multiple basal cell nevi carcinomas and skeletal abnormities. The syndrome may be diagnosed early by a dentist during the routine radiographic exams in the first decade of life, since the KCOTs are usually one of the first manifestations of the syndrome. This article reports the series of 3 cases, emphasizing its clinical and radiographic manifestations of GGS. PMID:25937738

  2. [Neonatal Pearson syndrome. two case studies].

    PubMed

    Collin-Ducasse, H; Maillotte, A-M; Monpoux, F; Boutté, P; Ferrero-Vacher, C; Paquis, V

    2010-01-01

    Among the etiologies of anemia in the newborn, those related to mitochondrial cytopathies are rare. Pearson syndrome is mostly diagnosed during infancy and characterized by refractory sideroblastic anemia with vacuolization of marrow progenitor cells and exocrine pancreatic dysfunction. We describe two diagnosed cases of Pearson syndrome in the early neonatal period caused by severe macrocytic aregenerative anemia. Bone marrow aspiration revealed sideroblastic anemia and vacuolization of erythroblastic precursors. The diagnosis was confirmed by genetic analysis revealing a deletion in the mitochondrial DNA. These two newborns received monthly transfusions. Five other newborns suffering from Pearson syndrome with various clinical symptoms were found in literature. Pearson syndrome, rarely diagnosed in newborns, should be suspected in the presence of macrocytic aregenerative anemia and requires a bone marrow aspirate followed by a genetic analysis from a blood sample. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  3. Down Syndrome and Fragile X Syndrome in a Colombian Woman: Case Report

    ERIC Educational Resources Information Center

    Saldarriaga, Wilmar; Ruiz, Fabian Andres; Tassone, Flora; Hagerman, Randi

    2017-01-01

    Background: Down syndrome (DS) and Fragile X syndrome (FXS) are the major genetic causes of intellectual disabilities. Here, we present a case of a 32-year-old woman with the diagnosis of both FXS and DS. She is the daughter of a 47-year-old pre-mutation woman who also has three sons with FXS. Methods: Cytogenetic testing detected the presence of…

  4. [Two cases of rehabilitation in Ehler-Danlos syndrome].

    PubMed

    Le Tallec, H; Lassalle, A; Khenioui, H; Durufle, A; Plassat, R; Gallien, P

    2006-03-01

    Ehlers-Danlos syndrome is rare and little known. It comprises a heterogeneous group of heritable connective tissue disorders characterized by articular hypermobility, skin extensibility and tissue fragility. Diagnosis may be difficult and often delayed. Here we describe 2 cases of women with Ehlers-Danlos syndrome. The first had scoliosis with back pain and joint hypermobility. The second presented with hypermobility and joint dislocation, which increased during pregnancy. In these 2 cases, rehabilitation management produced clinical improvement. Orthopaedic complications such joint pain, joint swelling, joint dislocation, back pain, with walking and hand function disability are the main problems in Ehlers-Danos syndrome. Surgery may be necessary to correct dislocated joints but is often not sufficient to resolve the handicap, and physical therapy has an important place in management. Ehlers-Danlos syndrome is an evolving disease that can lead to great impairment. Thus, physicians must be aware of this syndrome to offer the best management, with the appropriate use of orthotic devices, specific strengthening routines, education in proper body mechanics and assistive devices, to prevent joint dislocation and subluxations responsible for pain and handicap.

  5. Horner syndrome in glandular fever: a case report.

    PubMed

    West, E V; Sheerin, F; Bates, J E H M

    2016-02-01

    This study aimed to present and discuss the case of a patient with known glandular fever who presented with Horner syndrome. A 35-year-old patient with known glandular fever developed acute unilateral Horner syndrome, a previously undescribed complication of this common illness. Magnetic resonance imaging and magnetic resonance angiography showed that enlarged intra-carotid sheath lymphoid tissue was likely to be the underlying cause of sympathetic nerve disruption. The case is described, the anatomy of the sympathetic chain is discussed and possible alternative pathophysiological mechanisms are reviewed. This is the first report in the worldwide literature of Horner syndrome arising as a result of compression from enlarged lymph nodes in glandular fever.

  6. 7. VIEW OF HYDRAULIC HAMMER STAMPING PRESS ON SIDE A ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. VIEW OF HYDRAULIC HAMMER STAMPING PRESS ON SIDE A OF BUILDING 883. THIS TYPE OF PRESS WAS USED FOR BOTH STAINLESS STEEL AND FOR DEPLETED URANIUM. (7/2/86) - Rocky Flats Plant, Uranium Rolling & Forming Operations, Southeast section of plant, southeast quadrant of intersection of Central Avenue & Eighth Street, Golden, Jefferson County, CO

  7. Clinical Spectrum of Autoerythrocyte Sensitization Syndrome: A Series of Five Cases

    PubMed Central

    Thokchom, Nandakishore Singh; Pradeepa, D.; Hafi, N. A. Bishurul; Verma, Kapila

    2018-01-01

    Autoerythrocyte sensitization syndrome (Gardner Diamond syndrome or GDS) is a rare syndrome characterized by painful and spontaneous purpura commonly affecting adult women, and is mostly associated with psychiatric illness. Diagnosis is mainly based on clinical presentation, exclusion of other simulating diseases, and psychiatric evaluation. Only few cases have been reported till date. We report five cases of spontaneous purpura with a normal investigation profile, except for iron deficiency anemia in 1 patient, of which three had associated underlying psychiatric illness. Autoerythrocyte sensitization test was positive in all our cases. Patients presenting with painful bruises without significant medical history such as underlying bleeding disorder or drug history or history of trauma should be considered for autoerythrocyte sensitization syndrome, and managed accordingly. The present study is a case series of patients with characteristic features of autoerythrocyte sensitization syndrome, considering the rarity of the reports on its clinical spectra. PMID:29644197

  8. Neonatal Marfan Syndrome: Report of Two Cases

    PubMed Central

    Ghandi, Yazdan; S.Zanjani, Keyhan; Mazhari-Mousavi, Seyed-Eshagh; Parvaneh, Nima

    2013-01-01

    Background Neonatal Marfan syndrome is a rare and severe phenotype of this disease. A poor prognosis is anticipated due to the high probability of congestive heart failure, and mitral and tricuspid regurgitations with suboptimal response to medical therapy and difficulties in surgical management at an early age. Case Presentation We present two consecutive patients with this disease who are the first reported cases from Iran to the best of our knowledge. Unfortunately both of them died shortly after diagnosis. Conclusion Neonatal Marfan syndrome is reported from Iran and has a poor prognosis like the patients reported from elsewhere. PMID:23549323

  9. Carpal Tunnel Syndrome in Aberrant Muscle Syndrome: A Case Report and Review of the Literature.

    PubMed

    Steele, Jessica; Coombs, Christopher

    2018-06-01

    Aberrant Muscle Syndrome (AMS) is a rare congenital hand difference that is characterised by unilateral non-progressive muscular hyperplasia. The aetiology of aberrant muscle syndrome is not known, but a recently published case has shown a somatic PIK3CA activating mutation in a patient with AMS. Carpal tunnel syndrome (CTS) in children is rare. The most common causes are the mucopolysaccaridoses but space-occupying lesions have also been reported to cause CTS in children. We report the first case of CTS in a child with AMS successfully treated with open carpal tunnel release and excision of aberrant muscles.

  10. Gorlin-Goltz syndrome: A rare case report

    PubMed Central

    Pol, Chetan A; Ghige, Suvarna K; Kalaskar, Ritesh R; Gosavi, Suchitra R

    2013-01-01

    Gorlin-Goltz syndrome is an uncommon autosomal dominant inherited disorder characterized by numerous basal cell carcinomas, odontogenic keratocysts (OKCs) and musculoskeletal malformations. A rare case of this syndrome observed in a 13-year-old male patient is presented in which multiple OKCs were causing disfigurement of the lower jaw as well as displacement and malocclusion of the teeth. Early diagnosis and treatment of this syndrome is important to reduce the severity of complications including cutaneous and cerebral malignancy and oromaxillofacial deformation and destruction due to jaw cysts. PMID:24403808

  11. DRESS syndrome with thrombotic microangiopathy revealing a Noonan syndrome: Case report.

    PubMed

    Bobot, Mickaël; Coen, Matteo; Simon, Clémentine; Daniel, Laurent; Habib, Gilbert; Serratrice, Jacques

    2018-04-01

    The life-threatening drug rash with eosinophilia and systemic symptoms (DRESS) syndrome occurs most commonly after exposure to drugs, clinical features mimic those found with other serious systemic disorders. It is rarely associated with thrombotic microangiopathy. We describe the unique case of a 44-year-old man who simultaneously experienced DRESS syndrome with thrombotic microangiopathy (TMA) after a 5 days treatment with fluindione. Clinical evaluation leads to the discovery of an underlying lymphangiomatosis, due to a Noonan syndrome. The anticoagulant was withdrawn, and corticosteroids (1 mg/kg/day) and acenocoumarol were started. Clinical improvement ensued. At follow-up the patient is well. The association of DRESS with TMA is a rare condition; we believe that the presence of the underlying Noonan syndrome could have been the trigger. Moreover, we speculate about the potential interrelations between these entities.

  12. Gilles de la Tourette's syndrome in a patient with 47(XXX) syndrome: a case report

    PubMed Central

    2011-01-01

    Introduction To the best of our knowledge, this is the first report of a comorbidity between Gilles de la Tourette's syndrome and 47 (XXX) syndrome. The clinical picture of Gilles de la Tourette's Syndrome is well described, while 47 (XXX) syndrome is much more rare and has a broader spectrum of possible phenotypic presentations. Case presentation An Italian Caucasian girl was referred at the age of 11 to our Rehabilitation Center for anxiety and learning difficulties. The girl had already been diagnosed as having 47(XXX) syndrome; she had some rather typical features of the chromosomal abnormality, but she also showed a high level of anxiety and the presence of motor and vocal tics. When an accurate history was taken, a diagnosis of Gilles de la Tourette's Syndrome emerged. Conclusions The possible interaction between peculiar features of these two syndromes in terms of neuropsychological and affective functioning is both interesting for the specific case and to hypothesize models of rehabilitation for patients with one or both syndromes. Executive functions are specifically reduced in both syndromes, therefore it might be hard to discriminate the contribution of each one to the general impairment; the same applies to anxiety. Moreover, mental retardation (with a significantly lower verbal cognitive functioning) poses relevant problems when suggesting cognitive behavioral or psychoeducational rehabilitative approaches. PMID:22054059

  13. Successful treatment with tacrolimus in TAFRO syndrome: two case reports and literature review.

    PubMed

    Shirai, Taiichiro; Onishi, Akira; Waki, Daisuke; Saegusa, Jun; Morinobu, Akio

    2018-06-01

    TAFRO syndrome is a systemic inflammatory disorder characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly. In contrast to that in multicentric Castleman disease, interleukin-6 targeting strategies seem ineffective in some TAFRO syndrome cases; however, the optimal treatment remains unclear. Here, we report 2 cases of TAFRO syndrome, where 1 with cardiomyopathy, successfully treated with tacrolimus. This is the first case report of successful treatment with tacrolimus in TAFRO syndrome. Both patients (cases 1 and 2) developed fever, anasarca, thrombocytopenia, renal dysfunction, and mild hepatosplenomegaly. In both patients, lymph node pathology revealed mixed type Castleman disease-like features, and bone marrow showed reticulin myelofibrosis. TAFRO syndrome was diagnosed based on the patients' laboratory, clinical, and pathologic findings. In case 2, we observed a rare complication of cardiomyopathy with no evidence of takotsubo cardiomyopathy or viral myocarditis. In case 1, tocilizumab combined with glucocorticoids was ineffective and caused septic shock; additionally, cyclosporine A was discontinued because of hepatotoxicity. However, tacrolimus was effective in resolving TAFRO syndrome without any adverse events. In case 2, tacrolimus completely reversed TAFRO syndrome and was also effective in cardiomyopathy. This report suggests that tacrolimus is potentially effective and safe as an initial treatment and a glucocorticoid-sparing agent. Our literature review shows that calcineurin inhibitors, including tacrolimus, may be effective in TAFRO syndrome. Since previous studies indicate a role of Th1 inflammation in TAFRO syndrome pathogenesis, tacrolimus may, therefore, be effective in treating TAFRO syndrome.

  14. On the prediction of impact noise, V: The noise from drop hammers

    NASA Astrophysics Data System (ADS)

    Richards, E. J.; Carr, I.; Westcott, M.

    1983-06-01

    In earlier papers in this series, the concepts of "acceleration" and "ringing" noise have been studied in relation to impact machines, and values of radiation efficiency have been obtained for the various types of structural components. In the work reported in this paper the predicted and measured noise radiation from a drop hammer, both in full-scale and in {1}/{3}- scale model form, were examined. It is found that overall noise levels ( Leq per event) can be predicted from vibration measurements to within ± 1·5 dB, and to within ±2·5 dB in one-third octave bands. In turn this has permitted noise reduction techniques to be examined by studies of local component vibration levels rather than overall noise, a method which provides considerable enlightenment at the design stage. It is shown that on one particular drop hammer, the noise energy is shared surprisingly uniformly over four or five sources, and that when these have been reduced, the overall noise reduction is severely limited by the "acceleration" noise from the "tup" or "hammer" itself. As this is difficult to eliminate without a basic change in forging technology, it follows that "tup" enclosure or modification of the sharpness of the final "hard" impact are the only means available for any serious noise reduction. Also indicated is the reliability of using model techniques, suitably scaled in frequency and impulse magnitude, in developing machinery with impact characteristics.

  15. Water hammer reduces fouling during natural water ultrafiltration.

    PubMed

    Broens, F; Menne, D; Pothof, I; Blankert, B; Roesink, H D W; Futselaar, H; Lammertink, R G H; Wessling, M

    2012-03-15

    Today's ultrafiltration processes use permeate flow reversal to remove fouling deposits on the feed side of ultrafiltration membranes. We report an as effective method: the opening and rapid closing of a valve on the permeate side of an ultrafiltration module. The sudden valve closure generates pressure fluctuations due to fluid inertia and is commonly known as "water hammer". Surface water was filtrated in hollow fiber ultrafiltration membranes with a small (5%) crossflow. Filtration experiments above sustainable flux levels (>125 l (m2h)(-1)) show that a periodic closure of a valve on the permeate side improves filtration performance as a consequence of reduced fouling. It was shown that this effect depends on flux and actuation frequency of the valve. The time period that the valve was closed proved to have no effect on filtration performance. The pressure fluctuations generated by the sudden stop in fluid motion due to the valve closure are responsible for the effect of fouling reduction. High frequency recording of the dynamic pressure evolution shows water hammer related pressure fluctuations to occur in the order of 0.1 bar. The pressure fluctuations were higher at higher fluxes (higher velocities) which is in agreement with the theory. They were also more effective at higher fluxes with respect to fouling mitigation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. View south of hydraulic hammer in boilermakers shop (probably the ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View south of hydraulic hammer in boilermakers shop (probably the oldest piece of equipment in the yard, originally powered by steam) nameplate: United Engineers and FDRY. Co. Pittsburgh, Pa, USA Davy Brothers LTD. Patents - Aug 1, 1905, Feb, 1901, Sept 8, 1908 - 10000 lbs. - Naval Base Philadelphia-Philadelphia Naval Shipyard, Structure Shop, League Island, Philadelphia, Philadelphia County, PA

  17. A case report of acute myelogenous leukemia with Turner Syndrome.

    PubMed

    Siddiqui, Nadir; Ali Baig, Mirza Faris; Khan, Bilal Ahmed

    2017-09-01

    Turner Syndrome was diagnosed in a 45 years old female, known case of Acute Myeloid Leukaemia (AML) with maturation, on Bone Marrow biopsy. She presented with blurred vision, vertigo, exertional dyspnoea and insomnia. She did not show the typical features of Turner syndrome, but her cytogenetis confirmed the diagnosis. Bone marrow biopsy showed diffuse infiltration of blast cells with cellularity around 80-85% and haematopoietic suppression. Karyotype analysis showed: 45 X, -X, t (8; 21) (q22; q22) [According to The International System for Human Cytogenetic Nomenclature (ISCN)]. Turner syndrome is caused by partial or complete absence of second X chromosome in a female. It is known to have Cardiovascular and Reproductive complications but it is rare to find haematologic malignancies. There are few similar reported cases of AML associated with Turner syndrome, therefore this is a unique case presented to Jinnah Postgraduate Medical Center, Karachi, Pakistan and further research should be done to identify more similar cases to explore the prognostic significance of this association.

  18. [RS3PE syndrome: presentation of two cases].

    PubMed

    Parra Ródenas, J V; Calvo Catalá, J; González-Cruz Cervellera, M I; Cervera Moscardó, J; Valero Prieto, I

    1996-12-01

    Recently, the syndrome of remitting seronegative symmetrical synovitis with pitting edema (RS3PE), has been proposed. The RS3PE syndrome has an acute onset, does not produce bony erosions, with a predilection for elderly patients and an excellent prognosis. This condition distinguishing if from rheumatoid arthritis and polymyalgia rheumatica. The purpose is to call attention to a benign forms of arthritis in aging patients. We report two cases of RS3PE syndrome.

  19. Severe periodontitis in Marfan's syndrome: a case report.

    PubMed

    Straub, Antje M; Grahame, Rodney; Scully, Crispian; Tonetti, Maurizio S

    2002-07-01

    Connective tissue disorders, such as some forms of Ehlers-Danlos syndrome, have been associated with severe periodontitis. This report describes a case of Marfan's syndrome, an inherited disorder of connective tissue caused by mutations in the fibrillin-1 gene, in which the patient presented with severe periodontitis. At examination, an average full-mouth clinical attachment level loss of 5.6+/-2.1 mm, furcation involvement, and severe alveolar bone loss were observed in a 41-year-old Caucasian male. Tooth hypermobility was also present. This case appears to be the first documentation of severe periodontitis in a patient with Marfan's syndrome. It supports the hypothesis that a variety of connective tissue disorders may confer increased susceptibility to periodontal tissue breakdown.

  20. [Psychosis Associated With Fahr's Syndrome: A Case Report].

    PubMed

    Cassiani-Miranda, Carlos Arturo; Herazo-Bustos, Mariana; Cabrera-González, Armando; Cadena-Ramos, Ivan; Barrios-Ayola, Francisco

    2015-01-01

    Fahr syndrome (SF) is a rare neurological disorder, characterized by abnormal deposition of calcium in brain areas that control movement. The case is presented of a 41-year-old female with a convulsive syndrome, psychotic disorder, neurocognitive disorde,r and intellectual disability associated with bilateral brain calcifications and altered calcium/phosphorus metabolism in the context of hypoparathyroidism. Case report. The calcifications found in the patient could be the cause of psychotic symptoms and cognitive impairment. Diagnostic imaging, laboratory tests, psychiatric and neuropsychological assessments are presented. The clinical presentation of this case is compared with similar ones reported in the literature. Therapeutic approaches and clinical outcomes are described. Fahr's syndrome should be suspected in patients with neuropsychiatric disorders and seizures. Neuroimaging studies, and the determining of phosphorus and calcium metabolism and parathyroid hormone levels are important in this type of patient. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  1. Comparison of Amplitudes and Frequencies of Explosive vs. Hammer Seismic Sources for a 1-km Seismic Line in West Texas

    NASA Astrophysics Data System (ADS)

    Kaip, G.; Harder, S. H.; Karplus, M. S.; Vennemann, A.

    2016-12-01

    In May 2016, the National Seismic Source Facility (NSSF) located at the University of Texas at El Paso (UTEP) Department of Geological Sciences collected seismic data at the Indio Ranch located 30 km southwest of Van Horn, Texas. Both hammer on an aluminum plate and explosive sources were used. The project objective was to image subsurface structures at the ranch, owned by UTEP. Selecting the appropriate seismic source is important to reach project objectives. We compare seismic sources between explosions and hammer on plate, focusing on amplitude and frequency. The seismic line was 1 km long, trending WSW to ENE, with 200 4.5 Hz geophones at 5m spacing and shot locations at 10m spacing. Clay slurry was used in shot holes to increase shot coupling around booster. Trojan Spartan cast boosters (150g) were used in explosive sources in each shot hole (1 hole per station). The end of line shots had 5 shot holes instead of 1 (750g total). The hammer source utilized a 5.5 kg hammer and an aluminum plate. Five hammer blows were stacked at each location to improve signal-to-noise ratio. Explosive sources yield higher amplitude, but lower frequency content. The explosions exhibit a higher signal-to-noise ratio, allowing us to recognize seismic energy deeper and farther from the source. Hammer sources yield higher frequencies, allowing better resolution at shallower depths but have a lower signal-to-noise ratio and lower amplitudes, even with source stacking. We analyze the details of the shot spectra from the different types of sources. A combination of source types can improve data resolution and amplitude, thereby improving imaging potential. However, cost, logistics, and complexities also have a large influence on source selection.

  2. Successful treatment with tacrolimus in TAFRO syndrome: two case reports and literature review

    PubMed Central

    Shirai, Taiichiro; Onishi, Akira; Waki, Daisuke; Saegusa, Jun; Morinobu, Akio

    2018-01-01

    Abstract Rationale: TAFRO syndrome is a systemic inflammatory disorder characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly. In contrast to that in multicentric Castleman disease, interleukin-6 targeting strategies seem ineffective in some TAFRO syndrome cases; however, the optimal treatment remains unclear. Here, we report 2 cases of TAFRO syndrome, where 1 with cardiomyopathy, successfully treated with tacrolimus. This is the first case report of successful treatment with tacrolimus in TAFRO syndrome. Patient concerns: Both patients (cases 1 and 2) developed fever, anasarca, thrombocytopenia, renal dysfunction, and mild hepatosplenomegaly. Diagnoses: In both patients, lymph node pathology revealed mixed type Castleman disease-like features, and bone marrow showed reticulin myelofibrosis. TAFRO syndrome was diagnosed based on the patients’ laboratory, clinical, and pathologic findings. In case 2, we observed a rare complication of cardiomyopathy with no evidence of takotsubo cardiomyopathy or viral myocarditis. Interventions and outcomes: In case 1, tocilizumab combined with glucocorticoids was ineffective and caused septic shock; additionally, cyclosporine A was discontinued because of hepatotoxicity. However, tacrolimus was effective in resolving TAFRO syndrome without any adverse events. In case 2, tacrolimus completely reversed TAFRO syndrome and was also effective in cardiomyopathy. Lessons: This report suggests that tacrolimus is potentially effective and safe as an initial treatment and a glucocorticoid-sparing agent. Our literature review shows that calcineurin inhibitors, including tacrolimus, may be effective in TAFRO syndrome. Since previous studies indicate a role of Th1 inflammation in TAFRO syndrome pathogenesis, tacrolimus may, therefore, be effective in treating TAFRO syndrome. PMID:29879072

  3. [Analysis of the clinical audiological characteristics in 92 Chinese Alport syndrome cases].

    PubMed

    Chen, Li; Xue, Junfang; Zhang, Yanqin; Wang, Fang; Chen, Siqi; Duan, Jibo; Liu, Yuhe; Ding, Jie

    2014-11-01

    To analyze the clinical audiological characteristics in Chinese Alport syndrome, and investigate the relationship between the genotypes of Alport syndrome and hearing phenotype. The clinical hearing data of 92 cases diagnosed as Alport syndrome from 2008 August to 2013 August were reviewed and analyzed. All coding exons of COL4A3 and COL4A5 genes were PCR-amplified and sequenced from genomic DNA, or mRNA of COL4A5 gene was RT-PCR-amplified and sequenced from skin fibroblast in 17 cases. Eighty-seven out of 92 cases were found with X-linked dominant inheritance (XLAS); 5 cases with autosomal recessive (ARAS); 44 cases had normal hearing, but 14 young cases had abnormal OAE; 48 cases (52.2%, 35 male, 13 female) had sensorineural hearing loss. A total of 44 cases with XLAS had hearing loss (49.4%), wherein the incidence of hearing impairment was 55.0% in male XLAS, and 37.0% in female XLAS. Mild and moderate hearing loss were found in XLAS. Audiometric curves including groove type (21 cases), descending type (13 cases), flat type (10 cases), high frequency drop type (3 cases) and ascending type (1 case) were found in AS. Sixteen mutations of COL4A3, COL4A5 gene were found in 17 cases with Alport syndrome, including severe mutation in 8 cases with moderate hearing impairment. Mild and moderate hearing impairment, and groove type of audiometric curve are mainly found in Chinese Alport syndrome, which is different from Alport syndrome in western countries. OAE in the early diagnosis of hearing loss is important. Hearing phenotype is related certainly with genotype.

  4. [Denys-Drash syndrome: a case report].

    PubMed

    Puczko-Nogal, Barbara; Nogal, Paweł; Bilińska, Wiesława; Kulig, Andrzej; Nowicki, Michał

    2003-04-01

    Nephrotic syndrome (NS) rarely develops before the age of 1 year. The case is presented of nephrotic syndrome occurring in the form of Denys-Drash syndrome. In a newborn of female sex in birth certificate, dysmorphia was found of the external urogenital organs. The karyotype was 46XY. Massive proteinuria, low total serum protein level, dysproteinaemia, hypercholesterolaemia justified the diagnosis of NS. In renal biopsy performed diffuse mesangial fibrosis was found. The progression of renal insufficiency was very rapid and within few weeks terminal renal failure developed. The parents refused consent to renal replacement treatment. The baby died at the age of 102 days. The autopsy examination confirmed renal changes in the form of diffuse fibrosis; gonads of testicular structure were found in the abdominal cavity.

  5. [A case of Isaacs' syndrome associated with dextrocardia].

    PubMed

    Torres, L; Cosentino, C; Vélez, M; Anicama, A

    Isaacs syndrome is a disorder of unknown etiology characterized by muscular rigidity, cramps and myokymias. Described by Isaacs in 1961 and called by him as continuous muscular activity syndrome. There are few reports in Latino american countries. A 31 year-old man with sustained muscular contractions in lower limbs and diffuse myokymias since he was eighteen-year old. Dextrocardia was disclosed on clinical examination. We report the case of a patient with Isaacs syndrome and dextrocardia.

  6. Rumination syndrome in ethiopia: a case study.

    PubMed

    Bruni, Andrea

    2014-01-01

    Eating disorders are commonly believed to be rare or nonexistent in Africa. However, due to exposure to Western culture, a rise in eating disorders among African women is reported in the literature. This case study describes a 17-year-old Ethiopian girl who meets the DSM-IV-TR and DSM-5 diagnostic criteria for bulimia nervosa and the Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders criteria for rumination syndrome. The article discusses the diagnostic delays, the difficulties in terms of therapy, and the context determinants that-combined with individual psychopathological features-are thought to contribute to the disorders. Health professionals should be informed about the prevalence of eating disorders in Africa and, more specifically, of rumination syndrome in young women with normal intelligence. In light of this case study, it seems necessary to raise awareness with regard to the insufficient evidence on effective therapies for rumination syndrome in individuals without intellectual impairment.

  7. Rumination Syndrome in Ethiopia: A Case Study

    PubMed Central

    2014-01-01

    Eating disorders are commonly believed to be rare or nonexistent in Africa. However, due to exposure to Western culture, a rise in eating disorders among African women is reported in the literature. This case study describes a 17-year-old Ethiopian girl who meets the DSM-IV-TR and DSM-5 diagnostic criteria for bulimia nervosa and the Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders criteria for rumination syndrome. The article discusses the diagnostic delays, the difficulties in terms of therapy, and the context determinants that—combined with individual psychopathological features—are thought to contribute to the disorders. Health professionals should be informed about the prevalence of eating disorders in Africa and, more specifically, of rumination syndrome in young women with normal intelligence. In light of this case study, it seems necessary to raise awareness with regard to the insufficient evidence on effective therapies for rumination syndrome in individuals without intellectual impairment. PMID:25667799

  8. Impact of industrial hammer mill rotor speed on extraction efficiency and quality of extra virgin olive oil.

    PubMed

    Polari, Juan J; Garcí-Aguirre, David; Olmo-García, Lucía; Carrasco-Pancorbo, Alegría; Wang, Selina C

    2018-03-01

    Crushing is a key step during olive oil extraction. Among commercial crushers, the hammer mill is the most widely used due to its robustness and high throughput. In the present work, the impact of hammer mill rotor speed on extraction yield and overall quality of super-high-density Arbosana olive oils were assessed in an industrial facility. Our results show that increasing the rotor speed from 2400rpm to 3600rpm led to a rise in oil yield of 1.2%, while conserving quality parameters. Sensory analysis showed more pungency with increased rotation speed, while others attributes were unaffected. Volatile compounds showed little variation with the differences in crusher speed; however, total phenols content, two relevant secoiridoids, and triterpenoids levels increased with rotor speed. Hammer mill rotor speed is a processing variable that can be tuned to increase the extraction efficiency and modulate the chemical composition of extra virgin olive oil. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Anisotropy in Alpedrete granite cutting (Rift, Grain and Hardway directions) and effect on bush hammered heritage ashlars

    NASA Astrophysics Data System (ADS)

    Freire-Lista, David Martin; Fort, Rafael

    2015-04-01

    Many monuments and cities that are part of humanity's heritage have been built with carved granite ashlars. This dimension stone is one of the most used due to its abundance and durability. Traditional quarrymen have used anisotropic planes to cut granite blocks in the quarry for improved cutting performance. These planes are called Rift, Grain and Hardway (R, G, H) according to the ease of cutting. The aim of this study is to determine the response of each of the three orthogonal cutting planes R, G and H to the craft styling with bush hammer, based on their decay. Alpedrete granite was selected for this research, it is a monzogranite quarried in the Sierra de Guadarrana (Spanish Central System) foothills, in the province of Madrid, Spain. It is one of the most representative of Madrid's heritage granites. Alpedrete granite is also used as building stone in other European cities. From an Alpedrete granite bush hammered ashlar, three thin sections were cut parallel to the H plane; these thin sections cut R and G bush hammered planes. Also three thin sections have been cut parallel to the R plane at a distance of 2 mm, 10 mm and 30 mm from the bush hammered surface. All thin sections have been treated with fluorescein. In each of the thin sections a micrograph mosaic was performed covering the entire area (about 10 cm2, 300 photomicrographs) and printed with 120 increases. The length and spacing of inter-, intra- and trans-crystalline microcracks were quantified and measured. Microcracks were subdivided based on affected minerals in each R, G and H planes. Through these observations it was found that Alpedrete Granite R plane (easier to cut) is determined by exfoliation microcracks orientation. That is, R plane is parallel to the exfoliations microcracks, which are intra-crystalline and straight. The cutting of stones in the R plane is due to the coalescence of straight microcracks in the plane. This plane minimizes the effort and cost of subsequent carving so it

  10. [Neuropsychiatric symptoms in Sotos syndrome. Case report and review of the literature].

    PubMed

    Kessler, Holger; Kraft, Susanne

    2008-01-01

    Sotos syndrome, or cerebral gigantism, is a rare genetic syndrome characterized by excessive growth during childhood, macrocephaly, distinctive facial gestalt and learning difficulties. It is caused by mutations or deletions of the NSD-1 gene. Most cases are sporadic. Apart from a number of physical abnormalities that are commonly present, a high prevalence of cognitive, emotional and behavioural problems in children with Sotos syndrome can be assumed. However, there has been almost no literature about psychiatric symptoms in adults with Sotos syndrome so far; one case of psychosis was reported. In the present case, the authors present psychopathological features of an adult patient with Sotos syndrom who developed - among other things - psychotic symptoms.

  11. Intrapartum diagnostic of Roberts syndrome - case presentation.

    PubMed

    Socolov, Răzvan Vladimir; Andreescu, Nicoleta Ioana; Haliciu, Ana Maria; Gorduza, Eusebiu Vlad; Dumitrache, Florentin; Balan, Raluca Anca; Puiu, Maria; Dobrescu, Mihaela Amelia; Socolov, Demetra Gabriela

    2015-01-01

    Roberts syndrome is a rare disease, with multiple limb and skeletal abnormalities (called "pseudothalidomide disease"). There are only around 150 cases described in literature. We present a case of Roberts syndrome, diagnosed in moment of delivery, after a pregnancy without prenatal follow-up. The stillborn baby was naturally delivered by a 17-year-old primiparous woman at 38 weeks of amenorrhea. The pregnancy was not followed due to socioeconomic and family situation, and no prenatal ultrasound was performed. The male baby has 2650 g and presented several morphological abnormalities and tight double umbilical abdominal loop. The macroscopic evaluation showed: dolichocephaly, hypoplastic inferior maxilla with micrognathia, antimongoloid palpebral slant, pterygium colli, abnormal and lower implanted ears, superior limbs phocomelia, syndactyly at lower left limb and tetradactyly in all limbs, bilateral cryptorchidism, pancreatic aplasia. Roberts syndrome is a rare genetic disease with recessive autosomal transmission generated by mutations in ESCO2 gene, located on chromosome 8. The disease should be easy to diagnose by antenatal ultrasound examination, but in our case, the lack of prenatal follow-up determined the diagnostic at term. We believe consider this case is an argument towards introducing ultrasound-screening compulsory to all pregnancies. To identify a possible genetic mutation, further investigations of the parents are in progress, but classically the disease has a recessive autosomal transmission.

  12. Persistent Mullerian Duct Syndrome: an interesting case report.

    PubMed

    Farag, S; Sutton, P; Leow, K S; Kosai, N R; Razman, J; Hanafiah, H; Das, S

    2013-01-01

    Transverse testicular ectopia is an uncommon disorder of testicular ectopia. Nearly thirty percent of the cases is associated with Persistent mullerian duct syndrome which is characterized by karyotypically normal males with retained mullerian derivatives. Understanding the natural process of the condition and the association with malignant potential will allow for a better understanding of the optimal surgical approach. This is a case report of young male presented a left sided inguinal hernia in which the sac contained both testes and uterus. The literature review of the syndrome will be discussed.

  13. An Overlap Syndrome of Pigment Dispersion and Pigmentary Glaucoma accompanied by Marfan Syndrome: Case Report with Literature Review.

    PubMed

    Chakravarti, Tutul; Spaeth, George

    2013-01-01

    'Overlap syndrome' describes the situation in which two or more 'independent' conditions are present, either one of which could cause a particular finding. This current presentation reports a case with bilateral pigment dispersion syndrome (PDS), advanced pigmentary glaucoma (PG), and the Marfan syndrome, with bilateral subluxation of the lenses, and large short-term and long-term fluctuations of intraocular pressure. It is interesting to consider whether the associated advanced glaucomatous nerve damage could be a manifestation of just the PDS, just the Marfan syndrome, or rather a combination of these two overlapping independent conditions. How to cite this article: Chakravarti T, George S. An Overlap Syndrome of Pigment Dispersion and Pigmentary Glaucoma accompanied by Marfan Syndrome: Case Report with Literature Review. J Current Glau Prac 2013;7(2):91-95.

  14. Bobble-head doll syndrome associated with Dandy-Walker syndrome. Case report.

    PubMed

    de Brito Henriques, José Gilberto; Henriques, Karina Santos Wandeck; Filho, Geraldo Pianetti; Fonseca, Luiz Fernando; Cardoso, Francisco; Da Silva, Márcia Cristina

    2007-09-01

    Bobble-head doll syndrome (BHDS) presents in childhood and is usually associated with lesions of the third ventricle. This disorder is characterized by stereotypical head movements of the type "yes-yes" (up and down) at a frequency of 2 to 3 Hz. Rarely, movements of the type "no-no" (side-to-side) are described. There are a few hypotheses to explain the mechanism responsible for BHDS, but its real pathophysiological characteristics are still unknown. The authors describe the case of a child born with hydrocephalus and Dandy-Walker syndrome. A ventriculoperitoneal shunt was implanted in the child because of progressive head enlargement. One year after shunt placement, she began making frequent horizontal head movements of the type "no-no". There were no other signs or symptoms. Imaging studies demonstrated small ventricles and a posterior fossa cyst with no signs of hypertension. The child's growth, development, and head circumference (within the 5th percentile) remained satisfactory. Three aspects of this case were of interest: the association of BHDS with Dandy-Walker syndrome, the rare occurrence of BHDS of the "no-no" type, and the absence of third ventricle dilation. The authors' findings support the hypothesis that cerebellar malformations themselves can

  15. Classic Bartter syndrome complicated with profound growth hormone deficiency: a case report

    PubMed Central

    2013-01-01

    Introduction Classic Bartter syndrome is a salt-wasting tubulopathy caused by mutations in the CLCNKB (chloride channel Kb) gene. Although growth hormone deficiency has been suggested as a cause for persistent growth failure in patients with classic Bartter syndrome, in our opinion the diagnoses of growth hormone deficiency has been unconvincing in some reports. Moreover, Gitelman syndrome seems to have been confused with Bartter syndrome in some cases in the literature. In the present work, we describe a new case with CLCNKB gene mutations and review the reported cases of classic Bartter syndrome associated with growth hormone deficiency. Case presentation Our patient was a Japanese boy diagnosed as having classic Bartter syndrome at eight months of age. The diagnosis of Bartter syndrome was confirmed by CLCNKB gene analysis, which revealed compound heterozygous mutations with deletion of exons 1 to 3 (derived from his mother) and ΔL130 (derived from his father). His medical therapy consisted of potassium (K), sodium chloride, spironolactone, and anti-inflammatory agents; this regime was started at eight months of age. Our patient was very short (131.1cm, -4.9 standard deviation) at 14.3 years and showed profoundly impaired growth hormone responses to pharmacological stimulants: 0.15μg/L to insulin-induced hypoglycemia and 0.39μg/L to arginine. His growth response to growth hormone therapy was excellent. Conclusions The present case strengthens the association between classic Bartter syndrome and growth hormone deficiency. We propose that growth hormone status should be considered while treating children with classic Bartter syndrome. PMID:24377430

  16. The nasogastric tube syndrome: two case reports and review of the literature.

    PubMed

    Apostolakis, L W; Funk, G F; Urdaneta, L F; McCulloch, T M; Jeyapalan, M M

    2001-01-01

    The nasogastric tube syndrome is a potentially life-threatening complication of an indwelling nasogastric (NG) tube. The syndrome is thought to result from ulceration and infection of the posterior cricoid region with subsequent dysfunction of vocal cord abduction. This dysfunction may present as complete loss of vocal cord abduction manifested as serious airway compromise. Reports of this syndrome are infrequent, with only 29 cases published to date. Two additional cases of nasogastric tube syndrome diagnosed at the University of Iowa Hospitals and Clinics over a 2-year period are presented. A search of MEDLINE (1966 through February 1999), including review of those articles' references identified seven previous publications, including 29 case reports. These 29 cases are reviewed and the findings summarized. Twenty-nine cases of NG tube syndrome are identified, with 16 of these occurring in the preantibiotic period. Including the two cases presented here, 15 contemporary patients are examined. Among these 15 cases, 10 required tracheostomy, on average 8.5 days after NG tube placement. Although the fully manifested syndrome presents quite dramatically, we suspect that a clinical spectrum of severity exists with less severe cases going unrecognized. Consistent with previous reports, we found that direct visualization of the postcricoid region is required to rule out the diagnosis and recommend such action be taken whenever the diagnosis is suspected. Treatment should include establishment of a safe airway, removal of the tube whenever possible, antibiotic therapy, and antireflux therapy.

  17. [Acute pancreatitis and afferent loop syndrome. Case report].

    PubMed

    Barajas-Fregoso, Elpidio Manuel; Romero-Hernández, Teodoro; Macías-Amezcua, Michel Dassaejv

    2013-01-01

    The afferent syndrome loop is a mechanic obstruction of the afferent limb before a Billroth II or Roux-Y reconstruction, secondary in most of case to distal or subtotal gastrectomy. Clinical case: Male 76 years old, with antecedent of cholecystectomy, gastric adenocarcinoma six years ago, with subtotal gastrectomy and Roux-Y reconstruction. Beginning a several abdominal pain, nausea and vomiting, abdominal distension, without peritoneal irritation sings. Amylase 1246 U/L, lipase 3381 U/L. Computed Tomography with thickness wall and dilatation of afferent loop, pancreas with diffuse enlargement diagnostic of acute pancreatitis secondary an afferent loop syndrome. The afferent loop syndrome is presented in 0.3%-1% in all cases with Billroth II reconstruction, with a mortality of up to 57%, the obstruction lead accumulation of bile, pancreatic and intestinal secretions, increasing the pressure and resulting in afferent limb, bile conduct and Wirsung conduct dilatation, triggering an inflammatory response that culminates in pancreatic inflammation. The severity of the presentation is related to the degree and duration of the blockage.

  18. Subsurface sediment contamination during borehole drilling with an air-actuated down-hole hammer.

    PubMed

    Malard, Florian; Datry, Thibault; Gibert, Janine

    2005-10-01

    Drilling methods can severely alter physical, chemical, and biological properties of aquifers, thereby influencing the reliability of water samples collected from groundwater monitoring wells. Because of their fast drilling rate, air-actuated hammers are increasingly used for the installation of groundwater monitoring wells in unconsolidated sediments. However, oil entrained in the air stream to lubricate the hammer-actuating device can contaminate subsurface sediments. Concentrations of total hydrocarbons, heavy metals (Cu, Ni, Cr, Zn, Pb, and Cd), and nutrients (particulate organic carbon, nitrogen, and phosphorus) were measured in continuous sediment cores recovered during the completion of a 26-m deep borehole drilled with a down-hole hammer in glaciofluvial deposits. Total hydrocarbons, Cu, Ni, Cr and particulate organic carbon (POC) were all measured at concentrations far exceeding background levels in most sediment cores. Hydrocarbon concentration averaged 124 +/- 118 mg kg(-1) dry sediment (n = 78 samples) with peaks at depths of 8, 14, and 20 m below the soil surface (maximum concentration: 606 mg kg(-1)). The concentrations of hydrocarbons, Cu, Ni, Cr, and POC were positively correlated and exhibited a highly irregular vertical pattern, that probably reflected variations in air loss within glaciofluvial deposits during drilling. Because the penetration of contaminated air into the formation is unpreventable, the representativeness of groundwater samples collected may be questioned. It is concluded that air percussion drilling has strong limitations for well installation in groundwater quality monitoring surveys.

  19. [A unique case of secondary takotsubo syndrome].

    PubMed

    Arcari, Luca; Limite, Luca Rosario; Autore, Camillo; Volpe, Massimo; Musumeci, Maria Beatrice

    2018-04-01

    Takotsubo syndrome (TTS) is an acute cardiac syndrome characterized by transient systolic left ventricular dysfunction frequently preceded by stressful events. It typically affects postmenopausal women without angiographic evidence of obstructive coronary artery disease. We report here an uncommon occurrence of secondary TTS in a male with coronary artery disease after exogenous catecholamine administration and pacemaker implantation. This unexpected case suggests that, in such clinical scenario, a TTS diagnosis might be considered even in unsuspected individuals.

  20. Churg-Strauss syndrome in childhood: a case report.

    PubMed

    Albahri, Ziad; Minxová, Lenka; Lukeš, Antonín; Mawiri, Abdul Al; Štefáčková, Šárka

    2014-10-01

    Churg-Strauss syndrome is a rare form of small-vessel vasculitis. In the current report, we describe the case of a 17-year-old Czech girl predominantly characterized by peripheral neuropathy, the presence of cardiac and pulmonary involvement, hypereosinophilia, asthma, and sinusitis that led to the diagnosis of Churg-Strauss syndrome. © The Author(s) 2013.

  1. Cerebro-costo-mandibular syndrome: Report of two cases.

    PubMed

    Abdalla, Wael; Panigrahy, Ashok; Bartoletti, Stefano C

    2011-01-01

    Cerebro-costo-mandibular syndrome (CCMS) is a rare syndrome that includes a constellation of mandibular hypoplasia and posterior rib defects as its basic features. Additional features can include hearing loss, tracheal cartilage abnormalities, scoliosis, elbow hypoplasia, and spina bifida. Here we report two cases of CCMS and discuss the reported long-term outcome of the disease.

  2. Vertebrobasilar Dolichoectasia Induced Hydrocephalus: the Water-Hammer Effect

    PubMed Central

    Zisimopoulou, Vaso; Ntouniadaki, Aikaterini; Aggelidakis, Panagiotis; Siatouni, Anna; Gatzonis, Stylianos; Tavernarakis, Antonios

    2015-01-01

    Vertebrobasilar dolichoectasia is a clinical entity associated rarely with obstructive hydrocephalus. We present a 48-year old male with a profound dilatation of the ventricular system due to a dolichoectatic basilar artery, as appeared in imaging studies. The patient suffered from longstanding hydrocephalus and presenile dementia. The underlying mechanism for obstructive hydrocephalus due to vertebrobasilar dolichoectasia is considered to be both a water-hammer effect and a direct compression of adjacent structures. We suggest prompt surgical intervention upon diagnosis as a first choice treatment in order to avoid further complications. PMID:26236456

  3. Vertebrobasilar Dolichoectasia Induced Hydrocephalus: the Water-Hammer Effect.

    PubMed

    Zisimopoulou, Vaso; Ntouniadaki, Aikaterini; Aggelidakis, Panagiotis; Siatouni, Anna; Gatzonis, Stylianos; Tavernarakis, Antonios

    2015-04-24

    Vertebrobasilar dolichoectasia is a clinical entity associated rarely with obstructive hydrocephalus. We present a 48-year old male with a profound dilatation of the ventricular system due to a dolichoectatic basilar artery, as appeared in imaging studies. The patient suffered from longstanding hydrocephalus and presenile dementia. The underlying mechanism for obstructive hydrocephalus due to vertebrobasilar dolichoectasia is considered to be both a water-hammer effect and a direct compression of adjacent structures. We suggest prompt surgical intervention upon diagnosis as a first choice treatment in order to avoid further complications.

  4. DETAIL VIEW OF INTERIOR SHOWING TWO 3,000POUND STEAM HAMMERS, CA. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF INTERIOR SHOWING TWO 3,000-POUND STEAM HAMMERS, CA. 1905, CONVERTED TO COMPRESSED AIR 1985 (MANUFACTURED BY CHAMBERSBURG ENGINEERING COMPANY, CHAMBERSBURG, PENNSYLVANIA), LOCATED ON EITHER SIDE OF CAST-IRON CENTRAL SUPPORT COLUMN. - Cambria Iron Company, Blacksmith Shop, Lower Works, Johnstown, Cambria County, PA

  5. [Leigh syndrome: case report].

    PubMed

    Roma, Adriano de Carvalho; Pereira, Paula Resende Aquino de Assis; Dantas, Adalmir Morterá

    2008-01-01

    The authors describe for the first time in the Country a case of a 10-year-old female child, assisted at the Ophthalmology Clinic of the Hospital Universitário Clementino Fraga Filho UFRJ, with Leigh's syndrome that is part of a metabolic disease group known as mitochondrial encephalomyopathies. It is an hereditary disease transmitted by a different mode of inheritance: mitochondrial, X-linked recessive and autosomal recessive. The beginning of clinical manifestations is varied and occurs usually in the first two years of life, with progressive and insidious evolution and exacerbation periods. Diagnosis is difficult because pleomorphic presentation, based on clinical findings and complementary study related to mitochondrial production of ATP and cytochrome c oxidase deficiencies. Considering that there is no specific treatment, this is based on a palliative procedure. So, the identification of this syndrome is very important to keep it under control, since its evolution is progressive.

  6. Ambras Syndrome: First Reported Case in Bangladesh and its Oral Rehabilitation.

    PubMed

    Khan, M H; Ashrafuzzaman, S M; Taib, A N; Alam, M T; Khan, S H; Goldstein, S K; Rahman, R

    2015-10-01

    People with rare hypertrichosis syndromes became crowd-drawing money-making phenomena in many 19th century sideshow acts. These individuals have been referred to as dog-men, hair-men, and werewolves. In 1993, Baumister et al. described congenital hypertrichosis lanuginose or Ambras syndrome: a distinct form of congenital hypertrichosis characterized by excessive hair growth over the body and face associated with facial and occasional dental anomalies. Much is not known about this syndrome since fewer than 50 cases have been documented worldwide. In this case report, a nine year old girl presented with excessive hair growth throughout her body that was denser along her midline. Furthermore, her face displayed the typical dysmorphic features characteristic of Ambras syndrome: a round tip nose, thickened nasal cartilage, antiverted nares, prominent philtrum with deep groove, and a trapezoid mouth. Oral examination revealed normal oral mucosa with completely missing and unerupted decidious and permanent teeth. Panoramic radiographs confirmed unerupted deciduous teeth. Previous case reports have mentioned the presence of occasional dental anomalies such as retarded first and second dentition and absence of some teeth. However, this is the first reported case of Ambras syndrome presenting with complete anodontia. Prior cytogenetic studies performed on persons with Ambras syndrome have implicated a balanced pericentric inversion of chromosome 8. However, it is likely that dental anomalies are likely a result of a different genetic rearrangement. Further studies are needed to explore the cause of this rare phenotype of Ambras syndrome with complete unerupted dentition.

  7. Rett'S syndrome : a case report.

    PubMed

    Gupta, V

    2001-01-01

    Rett's syndrome is a rare condition affecting only the girl child. It presents as a pervasive developmental disorder with a remarkable behavioural phenotype. The cause for this remains unknown but genetic factors and brain dysfunction have been implicated. This case report emphasises the importance of being aware of rare yet significant disorders of interest to neuro-developmental psychiatrists.

  8. Spectrum of MLL2 (ALR) mutations in 110 cases of Kabuki syndrome.

    PubMed

    Hannibal, Mark C; Buckingham, Kati J; Ng, Sarah B; Ming, Jeffrey E; Beck, Anita E; McMillin, Margaret J; Gildersleeve, Heidi I; Bigham, Abigail W; Tabor, Holly K; Mefford, Heather C; Cook, Joseph; Yoshiura, Koh-ichiro; Matsumoto, Tadashi; Matsumoto, Naomichi; Miyake, Noriko; Tonoki, Hidefumi; Naritomi, Kenji; Kaname, Tadashi; Nagai, Toshiro; Ohashi, Hirofumi; Kurosawa, Kenji; Hou, Jia-Woei; Ohta, Tohru; Liang, Deshung; Sudo, Akira; Morris, Colleen A; Banka, Siddharth; Black, Graeme C; Clayton-Smith, Jill; Nickerson, Deborah A; Zackai, Elaine H; Shaikh, Tamim H; Donnai, Dian; Niikawa, Norio; Shendure, Jay; Bamshad, Michael J

    2011-07-01

    Kabuki syndrome is a rare, multiple malformation disorder characterized by a distinctive facial appearance, cardiac anomalies, skeletal abnormalities, and mild to moderate intellectual disability. Simplex cases make up the vast majority of the reported cases with Kabuki syndrome, but parent-to-child transmission in more than a half-dozen instances indicates that it is an autosomal dominant disorder. We recently reported that Kabuki syndrome is caused by mutations in MLL2, a gene that encodes a Trithorax-group histone methyltransferase, a protein important in the epigenetic control of active chromatin states. Here, we report on the screening of 110 families with Kabuki syndrome. MLL2 mutations were found in 81/110 (74%) of families. In simplex cases for which DNA was available from both parents, 25 mutations were confirmed to be de novo, while a transmitted MLL2 mutation was found in two of three familial cases. The majority of variants found to cause Kabuki syndrome were novel nonsense or frameshift mutations that are predicted to result in haploinsufficiency. The clinical characteristics of MLL2 mutation-positive cases did not differ significantly from MLL2 mutation-negative cases with the exception that renal anomalies were more common in MLL2 mutation-positive cases. These results are important for understanding the phenotypic consequences of MLL2 mutations for individuals and their families as well as for providing a basis for the identification of additional genes for Kabuki syndrome. Copyright © 2011 Wiley-Liss, Inc.

  9. Concrete density estimation by rebound hammer method

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ismail, Mohamad Pauzi bin, E-mail: pauzi@nm.gov.my; Masenwat, Noor Azreen bin; Sani, Suhairy bin

    Concrete is the most common and cheap material for radiation shielding. Compressive strength is the main parameter checked for determining concrete quality. However, for shielding purposes density is the parameter that needs to be considered. X- and -gamma radiations are effectively absorbed by a material with high atomic number and high density such as concrete. The high strength normally implies to higher density in concrete but this is not always true. This paper explains and discusses the correlation between rebound hammer testing and density for concrete containing hematite aggregates. A comparison is also made with normal concrete i.e. concrete containingmore » crushed granite.« less

  10. NEUROBILOGY OF ASPERGER'S SYNDROME : A CASE STUDY AND OVERVIEW

    PubMed Central

    Duggal, Harpreet S.; Dutta, Siddhartha; Sinha, Vinod K.; Basu, Soumya; Pandey, Smita; Nizamie, Haque S.; Nizamie, Alka

    2001-01-01

    Asperger's syndrome is an autistic spectrum disorder, which has engendered lesser attention in comparison to autism. Recent literature has focused on the involvement of cortical areas of the brain in this syndrome. We report a case of Asperger′s syndrome in which an extensive work-up, including neuropsychological, neurophysiological and neuroimaging procedures, were undertaken. The findings of the various investigative procedures are discussed and literature supporting the neurobiological basis of Asperger's syndrome is highlighted. Finally, we briefly touch upon the ‘Theory of Mind’ construct in autistic spectrum disorders. PMID:21407867

  11. The association between prune belly syndrome and dental anomalies: a case report

    PubMed Central

    2012-01-01

    Background Prune belly syndrome is a rare condition produced by an early mesodermal defect that causes abdominal abnormalities. However, the literature indicates that disturbances related to ectodermal development may also be present. This is the first case report in the literature to suggest that dental abnormalities are part of the broad spectrum of clinical features of prune belly syndrome. Because the syndrome causes many serious medical problems, early diagnosis of abnormalities involving the primary and permanent dentitions are encouraged. Case presentation The authors report the clinical case of a 4-year-old Caucasian boy with prune belly syndrome. In addition to the triad of abdominal muscle deficiency, abnormalities of the gastrointestinal and urinary tracts, and cryptorchidism, a geminated mandibular right central incisor, agenesis of a mandibular permanent left incisor, and congenitally missing primary teeth (namely, the mandibular right and left lateral incisors) were noted. Conclusion This original case report about prune belly syndrome highlights the possibility that dental abnormalities are a part of the broad spectrum of clinical features of the syndrome. Therefore, an accurate intra-oral clinical examination and radiographic evaluation are required for patients with this syndrome in order to provide an early diagnosis of abnormalities involving the primary and permanent dentitions. PMID:23249412

  12. The effect of cryogenic grinding and hammer milling on the flavour quality of ground pepper (Piper nigrum L.).

    PubMed

    Liu, Hong; Zeng, Fankui; Wang, Qinghuang; Ou, Shiyi; Tan, Lehe; Gu, Fenglin

    2013-12-15

    In this study, we compared the effects of cryogenic grinding and hammer milling on the flavour attributes of black, white, and green pepper. The flavour attributes were analysed using headspace solid-phase micro-extraction (HS-SPME) and gas chromatography-mass spectrometry (GC/MS), sensory evaluation and electronic nose (e-nose) analysis. Cryogenic grinding resulted in minimal damage to the colour, flavour, and sensory attributes of the spices. Cryogenic grinding was also better than hammer milling at preserving the main potent aroma constituents, but the concentrations of the main aroma constituents were dramatically reduced after storing the samples at 4 °C for 6 months. Pattern matching performed by the e-nose further supported our sensory and instrumental findings. Overall, cryogenic grinding was superior to hammer milling for preserving the sensory properties and flavour attributes of pepper without significantly affecting its quality. However, we found that the flavour quality of ground pepper was reduced during storage. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Dorsal dimelia in patau syndrome: a case report.

    PubMed

    Fattah, A; Pickford, M A

    2007-10-01

    We present a case of a child with Patau syndrome that exhibits features consistent with congenital palmar nail syndrome. The literature is reviewed and evidence presented to demonstrate that this is a defect in the dorso-ventral patterning of the limb and thus a form of dorsal dimelia. In order to differentiate this from other instances of ectopic nail tissue we suggest congenital palmar nail syndrome should be more specifically defined as duplicated nails, absent flexion creases, non-glabrous skin on the palmar surface, reduced movement at the interphalangeal joints and hypoplastic terminal phalanges.

  14. A Next Generation Sequencing custom gene panel as first line diagnostic tool for atypical cases of syndromic obesity: Application in a case of Alström syndrome.

    PubMed

    Maltese, Paolo E; Iarossi, Giancarlo; Ziccardi, Lucia; Colombo, Leonardo; Buzzonetti, Luca; Crinò, Antonino; Tezzele, Silvia; Bertelli, Matteo

    2018-02-01

    Obesity phenotype can be manifested as an isolated trait or accompanied by multisystem disorders as part of a syndromic picture. In both situations, same molecular pathways may be involved to different degrees. This evidence is stronger in syndromic obesity, in which phenotypes of different syndromes may overlap. In these cases, genetic testing can unequivocally provide a final diagnosis. Here we describe a patient who met the diagnostic criteria for Alström syndrome only during adolescence. Genetic testing was requested at 25 years of age for a final confirmation of the diagnosis. The genetic diagnosis of Alström syndrome was obtained through a Next Generation Sequencing genetic test approach using a custom-designed gene panel of 47 genes associated with syndromic and non-syndromic obesity. Genetic analysis revealed a novel homozygous frameshift variant p.(Arg1550Lysfs*10) on exon 8 of the ALMS1 gene. This case shows the need for a revision of the diagnostic criteria guidelines, as a consequence of the recent advent of massive parallel sequencing technology. Indications for genetic testing reported in these currently accepted diagnostic criteria for Alström syndrome, were drafted when sequencing was expensive and time consuming. Nowadays, Next Generation Sequencing testing could be considered as first line diagnostic tool not only for Alström syndrome but, more generally, for all those atypical or not clearly distinguishable cases of syndromic obesity, thus avoiding delayed diagnosis and treatments. Early diagnosis permits a better follow-up and pre-symptomatic interventions. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  15. A rare case of Gitelman's syndrome with hypophosphatemia.

    PubMed

    Akhtar, Naureen; Hafeez, Farkhanda

    2009-04-01

    Gitelman's syndrome is a hereditary disorder occurring due to loss of functional mutations of the gene encoding the distal convoluted tubule sodium chloride cotransporter (NCCT) and is characterized by hypokalemic metabolic alkalosis, hypomagnesemia and hypocalciuria. This case reports an adolescent girl presenting with episodes of carpopedal spasms and difficulty in walking with laboratory tests suggestive of Gitelman's syndrome along with hypophosphatemia.

  16. Intestinal adaptation in short bowel syndrome: A case report.

    PubMed

    Palla, Viktoria-Varvara; Karaolanis, Georgios; Pentazos, Panagiotis; Ladopoulos, Alexios; Papageorgiou, Evaggelos

    2015-06-01

    Short bowel syndrome is a clinical entity that includes loss of energy, fluid, electrolytes or micronutrient balance because of inadequate functional intestinal length. This case report demonstrates the case of a woman who compensated for short bowel syndrome through intestinal adaptation, which is a complex process worthy of further investigation for the avoidance of dependence on total parenteral nutrition and of intestinal transplantation in such patients. Copyright © 2015 Arab Journal of Gastroenterology. Published by Elsevier B.V. All rights reserved.

  17. MELAS Syndrome and Kidney Disease Without Fanconi Syndrome or Proteinuria: A Case Report.

    PubMed

    Rudnicki, Michael; Mayr, Johannes A; Zschocke, Johannes; Antretter, Herwig; Regele, Heinz; Feichtinger, René G; Windpessl, Martin; Mayer, Gert; Pölzl, Gerhard

    2016-12-01

    Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS syndrome) represents one of the most frequent mitochondrial disorders. The majority of MELAS cases are caused by m.3243A>G mutation in the mitochondrial MT-TL1 gene, which encodes the mitochondrial tRNA Leu(UUR) . Kidney involvement usually manifests as Fanconi syndrome or focal segmental glomerulosclerosis. We describe a patient with MELAS mutation, cardiomyopathy, and chronic kidney disease without Fanconi syndrome, proteinuria, or hematuria. While the patient was waitlisted for heart transplantation, her kidney function deteriorated from an estimated glomerular filtration rate of 33 to 20mL/min/1.73m 2 within several months. Kidney biopsy was performed to distinguish decreased kidney perfusion from intrinsic kidney pathology. Histologic examination of the biopsy specimen showed only a moderate degree of tubular atrophy and interstitial fibrosis, but quantitative analysis of the m.3243A>G mitochondrial DNA mutation revealed high heteroplasmy levels of 89% in the kidney. Functional assessment showed reduced activity of mitochondrial enzymes in kidney tissue, which was confirmed by immunohistology. In conclusion, we describe an unusual case of MELAS syndrome with chronic kidney disease without apparent proteinuria or tubular disorders associated with Fanconi syndrome, but widespread interstitial fibrosis and a high degree of heteroplasmy of the MELAS specific mutation and low mitochondrial activity in the kidney. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  18. [Radiculopathy in patients with Heerfordt's syndrome: two case presentations and review of the literature].

    PubMed

    Fukuhara, Kousuke; Fukuhara, Aika; Tsugawa, Jun; Oma, Shinji; Tsuboi, Yoshio

    2013-08-01

    As a subtype of the clinical presentations associated with sarcoidosis, the combination of uveitis, parotid gland swelling, and facial nerve palsy is known as Heerfordt's syndrome. This syndrome is an extremely rare disorder that has been estimated to affect only 4.1-5.6% of patients with sarcoidosis. We present 2 cases of Heerfordt's syndrome associated with radiculopathy in the trunk. The 2 patients experienced unilateral or bilateral radiculopathy in the trunk and in the trigeminal nerve area associated with Heerfordt's syndrome. Radiculopathy is also a rare manifestation in patients with neurosarcoidosis. A literature review revealed that only 51 cases of radiculopathy associated with sarcoidosis have been documented. A diagnosis of Heerfordt's syndrome was observed in 7 out of these 51 cases. Together with our 2 cases, 9 out of 53 patients with radiculopathy associated with sarcoidosis have been diagnosed as having Heerfordt's syndrome (estimated frequency, 16.9%). In conclusion, radiculopathy is a common neurological manifestation in patients with Heerfordt's syndrome. On the basis of our experience, we suggest that physicians consider the possibility of Heerfordt's syndrome in cases of radiculopathy with unknown cause.

  19. [Rectal cancer and Trousseau syndrome. Case report].

    PubMed

    Sierra-Montenegro, Ernesto; Sierra-Luzuriaga, Gastón; Calle-Loffredo, Daniel; Rodríguez Quinde, Miguel

    2013-01-01

    The Trousseau syndrome, first described in 1865, is the relationship of venous thromboembolisms and cancer. We present a case with rectal cancer and Trousseau syndrome. Female 40 years old, went to the Coloproctology Service for painless bleeding. A computed tomography report showed a tumor of 5 by 6 cm up 5 cm from the anal margin. Ultra-low anterior resection with colonic reservoir and loop ileostomy surgery was performed. The pathology report showed a semidiferenciate adenocarcinoma of the rectum and we established the stage as T3N0M0. Within 72 hours of her operation, she experienced sudden hypotension and painful abdominal distention. A second surgery was done finding necrosis of the colon from the splenic angle until the colonic reservoir with thrombi in the left colic artery, ischemic signs of bilateral fallopian tubes, ovaries, uterus, pelvic floor and the small intestine, 40 cm before ileostomy and ileon. Left hemicolectomy and colostomy was done. She was taken to intensive care where continuous administration of heparin was given; she died within 5 days because of multiorgan failure. The mechanism for this syndrome was unknown but there are several hypotheses, suggesting that hematological cancer patients are at an increased risk of deep vein thrombosis. Pancreatic cancer is the most common presentation with this syndrome (in 50% of cases). We suggested continuing with the standards of prevention of thromboembolism.

  20. A Case of Miller Fisher Syndrome, Thromboembolic Disease, and Angioedema: Association or Coincidence?

    PubMed

    Salehi, Nooshin; Choi, Eric D; Garrison, Roger C

    2017-01-16

    BACKGROUND Miller Fisher Syndrome is characterized by the clinical triad of ophthalmoplegia, ataxia, and areflexia, and is considered to be a variant of Guillain-Barre Syndrome. Miller Fisher Syndrome is observed in approximately 1-5% of all Guillain-Barre cases in Western countries. Patients with Miller Fisher Syndrome usually have good recovery without residual deficits. Venous thromboembolism is a common complication of Guillain-Barre Syndrome and has also been reported in Miller Fisher Syndrome, but it has generally been reported in the presence of at least one prothrombotic risk factor such as immobility. A direct correlation between venous thromboembolism and Miller Fisher Syndrome or Guillain-Barre Syndrome has not been previously described. CASE REPORT We report the case of a 32-year-old Hispanic male who presented with acute, severe thromboembolic disease and concurrently demonstrated characteristic clinical features of Miller Fisher Syndrome including ophthalmoplegia, ataxia, and areflexia. Past medical and family history were negative for thromboembolic disease, and subsequent hypercoagulability workup was unremarkable. During the course of hospitalization, the patient also developed angioedema. CONCLUSIONS We describe a possible association between Miller Fisher Syndrome, thromboembolic disease, and angioedema.

  1. Classic Bartter syndrome complicated with profound growth hormone deficiency: a case report.

    PubMed

    Adachi, Masanori; Tajima, Toshihiro; Muroya, Koji; Asakura, Yumi

    2013-12-30

    Classic Bartter syndrome is a salt-wasting tubulopathy caused by mutations in the CLCNKB (chloride channel Kb) gene. Although growth hormone deficiency has been suggested as a cause for persistent growth failure in patients with classic Bartter syndrome, in our opinion the diagnoses of growth hormone deficiency has been unconvincing in some reports. Moreover, Gitelman syndrome seems to have been confused with Bartter syndrome in some cases in the literature. In the present work, we describe a new case with CLCNKB gene mutations and review the reported cases of classic Bartter syndrome associated with growth hormone deficiency. Our patient was a Japanese boy diagnosed as having classic Bartter syndrome at eight months of age. The diagnosis of Bartter syndrome was confirmed by CLCNKB gene analysis, which revealed compound heterozygous mutations with deletion of exons 1 to 3 (derived from his mother) and ΔL130 (derived from his father). His medical therapy consisted of potassium (K), sodium chloride, spironolactone, and anti-inflammatory agents; this regime was started at eight months of age. Our patient was very short (131.1cm, -4.9 standard deviation) at 14.3 years and showed profoundly impaired growth hormone responses to pharmacological stimulants: 0.15μg/L to insulin-induced hypoglycemia and 0.39μg/L to arginine. His growth response to growth hormone therapy was excellent. The present case strengthens the association between classic Bartter syndrome and growth hormone deficiency. We propose that growth hormone status should be considered while treating children with classic Bartter syndrome.

  2. Cyclical vomiting syndrome secondary to a Chiari I malformation-a case report.

    PubMed

    White, William L; Bagga, Veejay; Campbell, David I; Hart, Anthony R; Ushewokunze, Shungu

    2017-12-01

    Cyclical vomiting syndrome is a disorder characterised by recurrent episodes of profuse vomiting. There are no cases in the literature on the management of children with presenting with cyclical vomiting syndrome and a Chiari malformation type I. We report the case of a 12-year-old child diagnosed with cyclical vomiting syndrome and a Chiari malformation type I. The patient received symptomatic relief following a craniocervical decompression.

  3. RETT'S SYNDROME : A CASE REPORT

    PubMed Central

    Gupta, Vinay

    2001-01-01

    Rett's syndrome is a rare condition affecting only the girl child. It presents as a pervasive developmental disorder with a remarkable behavioural phenotype. The cause for this remains unknown but genetic factors and brain dysfunction have been implicated. This case report emphasises the importance of being aware of rare yet significant disorders of interest to neuro-developmental psychiatrists. PMID:21407847

  4. A Rare Case of Michelin Tire Baby Syndrome in a Newborn.

    PubMed

    Ramphul, Kamleshun; Mejias, Stephanie G; Ramphul-Sicharam, Yogeshwaree

    2018-02-24

    Kunze-Riehm syndrome also known as Michelin tire baby syndrome (MTBS) is a rare genetic condition with a characteristic generalized folding of excess skin. The diagnosis is usually made based on clinical symptoms. There are approximately only 30 cases reported in the literature and some cases were associated with non-cutaneous anomalies as well. Herein, we report a case of MTBS in a five-day-old male of Iraqi origin.

  5. Churg Strauss syndrome associated with montelukast--case report.

    PubMed

    Man, Milena Adina; Alexandrescu, Dana; Pop, Monica; Trofor, Antigona

    2012-01-01

    Churg-Strauss Syndrome (allergic granulomatous angiitis) is a rare systemic and pulmonary vasculitis. We report the case of a 62 years old female, non-smoker, with a 20 years history of moderate persistent asthma treated with Salmeterol/Fluticasone 50/500 microg bid for 5 years and supplemental Montelukast in the past 5 months. The patient was admitted in our hospital with fever, malaise, sensory deficits in the lower extremities, diffuse musculoskeletal and thoracic pain. Blood eosinophil was 38% of her total WBC, thoracic computed tomography evidenced ill-defined groundglass attenuation predominantly involving the lateral segment of the middle lobe. Pulmonary infiltrates with eosinophilia can be used to define eosinophilic lung diseases. We made the differential diagnosis of eosinophilic lung disease: acute or chronic eosinophilic pneumonias, allergic bronchopulmonary aspergillosis, Loffler syndrome, Churg-Strauss syndrome, bronchocentric granulomatousis, idiopathic hypereosinophilic syndromes. Bronchoalveolar lavage showed 14.6% eosinophils. Few days after hospital admission patient experienced nausea, vomiting and diarrhea. She underwent a digestive endoscopy, which showed eosinophilic enteritis according to colon biopsy. Nasal mucosa biopsy found granulomas. Anti-neutrophil cytoplasmatic antibody (ANCA) was positive at 1:20. She displayed more than four American College of Rheumatology (ACR) criteria for Churg-Strauss Syndrome (developed while she was receiving montelukast therapy). Discontinuation of Montelukast and association of oral prednisone (1 mg/kgc) induced rapid improvement of symptoms and rapid decrease of peripheric eosinophils (72 hours). This case report illustrates the importance of early diagnosis of Churg-Strauss syndrome and the possible pathogenic link between leukotriene receptor antagonist use and CSS development.

  6. Associated congenital anomalies among cases with Down syndrome.

    PubMed

    Stoll, Claude; Dott, Beatrice; Alembik, Yves; Roth, Marie-Paule

    2015-12-01

    Down syndrome (DS) is the most common congenital anomaly widely studied for at least 150 years. However, the type and the frequency of congenital anomalies associated with DS are still controversial. Despite prenatal diagnosis and elective termination of pregnancy for fetal anomalies, in Europe, from 2008 to 2012 the live birth prevalence of DS per 10,000 was 10. 2. The objectives of this study were to examine the major congenital anomalies occurring in infants and fetuses with Down syndrome. The material for this study came from 402,532 consecutive pregnancies of known outcome registered by our registry of congenital anomalies between 1979 and 2008. Four hundred sixty seven (64%) out of the 728 cases with DS registered had at least one major associated congenital anomaly. The most common associated anomalies were cardiac anomalies, 323 cases (44%), followed by digestive system anomalies, 42 cases (6%), musculoskeletal system anomalies, 35 cases (5%), urinary system anomalies, 28 cases (4%), respiratory system anomalies, 13 cases (2%), and other system anomalies, 26 cases (3.6%). Among the cases with DS with congenital heart defects, the most common cardiac anomaly was atrioventricular septal defect (30%) followed by atrial septum defect (25%), ventricular septal defect (22%), patent ductus arteriosus (5%), coarctation of aorta (5%), and tetralogy of Fallot (3%). Among the cases with DS with a digestive system anomaly recorded, duodenal atresia (67%), Hirschsprung disease (14%), and tracheo-esophageal atresia (10%) were the most common. Fourteen (2%) of the cases with DS had an obstructive anomaly of the renal pelvis, including hydronephrosis. The other most common anomalies associated with cases with DS were syndactyly, club foot, polydactyly, limb reduction, cataract, hydrocephaly, cleft palate, hypospadias and diaphragmatic hernia. Many studies to assess the anomalies associated with DS have reported various results. There is no agreement in the literature as to

  7. Guillain-Barré syndrome complicating dengue fever: Two case reports.

    PubMed

    Boo, Yang Liang; Aris, Mohd Azman M; Chin, Pek Woon; Sulaiman, Wan Aliaa Wan; Basri, Hamidon; Hoo, Fan Kee

    2016-01-01

    Guillain-Barré syndrome is a rare neurological manifestation associated with dengue infection. More common antecedent infections include Campylobacter jejuni and Cytomegalovirus infection. Here, we report two cases of Guillain-Barré syndrome complicating dengue infection.

  8. Numerical investigation of soil plugging effect inside sleeve of cast-in-place piles driven by vibratory hammers in clays.

    PubMed

    Xiao, Yong Jie; Chen, Fu Quan; Dong, Yi Zhi

    2016-01-01

    During driving sleeve of cast-in-place piles by vibratory hammers, soils were squeezed into sleeve and then soil plugging was formed. The physic-mechanical properties of the soil plug have direct influence on the load transmission between the sleeve wall and soil plug. Nevertheless, the researches on this issue are insufficient. In this study, finite element and infinite element coupling model was introduced, through the commercial code ABAQUS, to simulate the full penetration process of the sleeve driven from the ground surface to the desired depth by applying vibratory hammers. The research results indicated that the cyclic shearing action decreases both in soil shear strength and in granular cementation force when the sleeve is driven by vibratory hammers, which leads to a partially plugged mode of the soil plug inside the sleeve. Accordingly, the penetration resistance of sleeve driven by vibratory hammers is the smallest compared to those by other installation methods. When driving the sleeve, the annular soil arches forming in the soil plug at sleeve end induce a significant rise in the internal shaft resistance. Moreover, the influence of vibration frequencies, sleeve diameters, and soil layer properties on the soil plug was investigated in detail, and at the same time improved formulas were brought forward to describe the soil plug resistance inside vibratory driven sleeve.

  9. Modified metabolic syndrome and second cancers in women: A case control study.

    PubMed

    Ortiz-Mendoza, Carlos-Manuel; Pérez-Chávez, Ernesto; Fuente-Vera, Tania-Angélica De-la

    2016-01-01

    According to some studies, the metabolic syndrome causes diverse primary cancers; however, there is no evidence about metabolic syndrome impact on second cancers development in women. To find out the implication of the modified metabolic syndrome in women with second cancers. This was a case-control study, at a general hospital in Mexico City, in women with second cancers (cases) and age-matched women with only one neoplasm (controls). The analysis comprised: Tumor (s), anthropometric features, and body mass index (BMI); moreover, presence of diabetes mellitus, hypertension, and fasting serum levels of total cholesterol, triglycerides and glucose. The sample was of nine cases and 27 controls. In cases, the metabolic syndrome (diabetes mellitus or glucose > 99 mg/dL + hypertension or blood pressure ≥ 135/85 mm Hg + triglycerides > 149 mg/dL or BMI ≥ 30 kg/m 2 ) was more frequent (odds ratio 20.8, 95% confidence interval: 1.9-227.1). Our results suggest that in women, the modified metabolic syndrome may be a risk factor for second cancers.

  10. Gorlin-Goltz Syndrome: A Rare Case Report of a 11-Year-Old Child.

    PubMed

    Tandon, Sandeep; Chauhan, Yashwant; Sharma, Meenakshi; Jain, Manish

    2016-01-01

    Gorlin-Goltz Syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS), is an autosomal dominant trait caused due to mutations in the patched tumor suppressor gene (PTCH) gene found on the long arm of chromosome 9. The syndrome is characterized by the presence of odontogenic keratocysts (OKCs), basal cell carcinomas, and skeletal malformations. Early diagnosis of the syndrome can be done by pedodontist as OKC is one of the early manifestations of the syndrome. Early diagnosis and treatment is important for long-term prognosis of the syndrome by reducing the severity of cutaneous carcinomas and deformities due to jaw cyst. The present case describes an 11-year-old patient with some typical features of NBCCS, which were diagnosed through its oral and maxillofacial manifestations. This case emphasizes the importance of pedodontist in early recognition of the syndrome. Tandon S, Chauhan Y, Sharma M, Jain M. Gorlin-Goltz Syndrome: A Rare Case Report of a 11-Year-Old Child. Int J Clin Pediatr Dent 2016;9(3):264-268.

  11. Gorlin-Goltz Syndrome: A Rare Case Report of a 11-Year-Old Child

    PubMed Central

    Tandon, Sandeep; Chauhan, Yashwant; Jain, Manish

    2016-01-01

    Gorlin-Goltz Syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS), is an autosomal dominant trait caused due to mutations in the patched tumor suppressor gene (PTCH) gene found on the long arm of chromosome 9. The syndrome is characterized by the presence of odontogenic keratocysts (OKCs), basal cell carcinomas, and skeletal malformations. Early diagnosis of the syndrome can be done by pedodontist as OKC is one of the early manifestations of the syndrome. Early diagnosis and treatment is important for long-term prognosis of the syndrome by reducing the severity of cutaneous carcinomas and deformities due to jaw cyst. The present case describes an 11-year-old patient with some typical features of NBCCS, which were diagnosed through its oral and maxillofacial manifestations. This case emphasizes the importance of pedodontist in early recognition of the syndrome. How to cite this article Tandon S, Chauhan Y, Sharma M, Jain M. Gorlin-Goltz Syndrome: A Rare Case Report of a 11-Year-Old Child. Int J Clin Pediatr Dent 2016;9(3):264-268. PMID:27843260

  12. Psi Chi/APA Edwin B. Newman Graduate Research Award: Joseph H. Hammer

    ERIC Educational Resources Information Center

    American Psychologist, 2009

    2009-01-01

    Joseph H. Hammer, recipient of the Psi Chi/APA Edwin B. Newman Graduate Research Award, is cited for an outstanding research paper whose findings provide important evidence regarding the promise of a male-sensitive approach to mental health marketing and empirically support the inclusion of theory-driven enhancements in group-targeted mental…

  13. [Anticonvulsant Hypersensitivity Syndrome: A Case Report].

    PubMed

    Valderrama Escudero, Felipe; Montoya González, Laura Elisa

    2014-01-01

    DRESS syndrome (skin reaction with eosinophilia and systemic symptoms) is an idiosyncratic drug reaction characterized by rash, fever, lymphadenopathy, and internal organ dysfunction. This case report is on a patient with bipolar affective disorder who presented with a systemic inflammatory response associated with the use of valproic acid, and an important activation of symptoms when used with other drugs with a different pharmacological action mechanism. The diagnosis of DRESS syndrome is primarily by exclusion, and its detection may be difficult, which could potentially become fatal for the patient. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  14. Comparison of Electrostatic Fins with Piezoelectric Impact Hammer Techniques to Extend Impulse Calibration Range of a Torsional Thrust Stand (Preprint)

    DTIC Science & Technology

    2011-03-23

    prac- tical max impulse to 1mNs. The newly developed Piezo - electric Impact Hammer (PIH) calibration system over- comes geometric limits of ESC...the fins to behave as part of an LRC circuit which results in voltage oscillations. By adding a resistor in series between the pulse generator and...series resistor as well as the effects of no loading on the pulse generator. III. PIEZOELECTRIC IMPACT HAMMER SYSTEM The second calibration method tested

  15. A Case of a TSH-secreting Pituitary Adenoma Associated with Evans' Syndrome.

    PubMed

    Yasuda, Atsushi; Seki, Toshiro; Oki, Masayuki; Takagi, Atsushi; Inomoto, Chie; Nakamura, Naoya; Atsumi, Hideki; Baba, Tanefumi; Matsumae, Mitsunori; Sasaki, Noriko; Suzuki, Yasuo; Fukagawa, Masafumi

    2015-06-20

    We present a case of a TSH-secreting pituitary adenoma (TSHoma) associated with Evans' syndrome. A 30-year-old woman was referred to our hospital due to purpura and ecchymoses on her limb and body and epistaxis. Evans' syndrome was diagnosed based on idiopathic thrombocytopenic purpura and autoimmune hemolytic anemia. She had a history of malocclusion and thyroid gland enlargement 4 years prior to admission. Endocrinological tests and magnetic resonance imaging also revealed that this patient had hyperthyroidism due to the TSHoma and that this adenoma concomitantly secreted GH. Recently, several cases of Evans' syndrome were associated with hyperthyroidism caused by autoimmune thyroid disease, such as Graves' disease, suggesting that these 2 conditions may have a common immunological basis. To the best of our knowledge, there is no case report of Evans' syndrome associated with hyperthyroidism due to TSHoma. Our report suggests that the excess of thyroid hormone itself promotes autoimmunity in Evans' syndrome. Thus, early treatment for hyperthyroidism is necessary in TSHomas because of the possibility that thyroid hormone normalization may prevent the development of Evans' syndrome.

  16. Use of Hemadsorption in a Case of Pediatric Toxic Shock Syndrome

    PubMed Central

    Berkes, Andrea; Szikszay, Edit; Kerényi, Adrienne; Szabó, Tamás; Ujhelyi, László; Bari, Krisztina; Balla, György

    2017-01-01

    Background Toxic shock syndrome is a potentially fatal toxin-mediated disease. The role of toxins in this clinical entity made us hypothesize that extracorporeal blood purification with CytoSorb® could play a beneficial role in the clinical management of toxic shock syndrome. This case report describes the successful treatment of toxic shock syndrome using a combination of renal replacement therapy and hemadsorption in a pediatric patient. Case Presentation A 5-year-old girl with Down's syndrome presented with an inflamed area surrounding an insect bite, signs of systemic inflammation, and multiple organ failure. As previous attempts of immune modulation therapy were unsuccessful, renal replacement therapy was supplemented by the cytokine absorber CytoSorb. Treatment using this combination was associated with a rapid and significant stabilization in the hemodynamic situation and a decrease in inflammatory mediators within hours after the initiation of therapy. The application of CytoSorb therapy was simple and safe. Conclusion The use of extracorporeal blood purification with CytoSorb proved potentially beneficial by removing toxins and inflammatory mediators in this case and could therefore play a role in the clinical management of toxic shock syndrome. Whether CytoSorb has the potential to even positively influence mortality in patients with toxic shock syndrome still needs to be confirmed. PMID:28791185

  17. Nance-Horan syndrome: a contiguous gene syndrome involving deletion of the amelogenin gene? A case report and molecular analysis.

    PubMed

    Franco, E; Hodgson, S; Lench, N; Roberts, G J

    1995-03-01

    A case of Nance-Horan syndrome in a male is presented, with some features of the condition in his carrier mother and her mother. It is proposed that Nance-Horan syndrome might be a contiguous gene syndrome mapping to chromosome Xp21.2-p22.3. The proband had congenital cataract microphthalmia and dental abnormalities including screwdriver shaped incisors and evidence of enamel pitting hypoplasia. The region Xp21.2-p22.3 also contains the tooth enamel protein gene, amelogenin (AMGX). Using molecular genetic techniques, we have shown that there is no evidence that the AMGX gene is deleted in this case of the Nance-Horan syndrome.

  18. Study on the Effect of the Impact Location and the Type of Hammer Tip on the Frequency Response Function (FRF) in Experimental Modal Analysis of Rectangular Plates

    NASA Astrophysics Data System (ADS)

    Mali, K. D.; Singru, P. M.

    2018-03-01

    In this work effect of the impact location and the type of hammer tip on the frequency response function (FRF) is studied. Experimental modal analysis of rectangular plates is carried out for this purpose by using impact hammer, accelerometer and fast Fourier transform (FFT) analyzer. It is observed that the impulse hammer hit location has, no effect on the eigenfrequency, yet a difference in amplitude of the eigenfrequencies is obtained. The effect of the hammer tip on the pulse and the force spectrum is studied for three types of tips metal, plastic and rubber. A solid rectangular plate was excited by using these tips one by one in three different tests. It is observed that for present experimental set up plastic tip excites the useful frequency range.

  19. An unusual case of ectopic ACTH syndrome.

    PubMed

    Willhauck, M J; Pöpperl, G; Rachinger, W; Giese, A; Auernhammer, C J; Spitzweg, C

    2012-02-01

    Ectopic ACTH-syndrome is a rare cause of Cushing's disease. Despite extensive diagnostic procedures the source of ACTH secretion often remains occult. This case describes a 45-year old woman with an ectopic Cushing's syndrome. Extensive imaging procedures including CT scan of chest and abdomen, octreotide scan and MRI of the chest and pituitary did not reveal the source of ACTH secretion. In consideration of an occult source of ACTH secretion we started a therapeutic trial with cabergoline (0.5 mg/d), a dopamine receptor agonist, which has been shown to be effective in ectopic Cushing's syndrome. 2 months after cabergoline treatment had been initiated, ACTH and cortisol levels normalized in association with significant improvement of the clinical symptoms. During follow-up a [(68)Ga-DOTA-dPhe(1), Tyr(3)]-octreotate ([(68)Ga-DOTA]-TATE) PET-CT was performed revealing a somatostatin receptor positive lesion in the right sphenoidal sinus suggesting the source of ACTH secretion. The patient was cured by transnasal resection of the polypoid lesion, which was immunohistochemically characterized as an ACTH-positive neuroendocrine tumor. This case report demonstrates the management of ectopic ACTH-syndrome by molecularly -targeted therapy with dopamine receptor -agonists as well as improved detection of the ectopic ACTH source by novel imaging modalities, such as [(68)Ga-DOTA]-TATE PET specifically targeting somatostatin receptor subtype-2 with high affinity. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  20. Kounis Syndrome During Anesthesia: Presentation of Indolent Systemic Mastocytosis: A Case Report.

    PubMed

    de la Fuente Tornero, Elena; Vega Castro, Arantza; de Sierra Hernández, Pedro Álvarez; Balaguer Recena, Javier; Zaragoza Casares, Sofía Carmen; Serrano Baylin, Francisco Miguel; Gallardo Culebradas, Paloma; Amorós Alfonso, Beatriz; Rodríguez Fraile, Jose Ramón

    2017-05-01

    Mastocytosis comprises a heterogeneous group of disorders characterized by mast cell accumulation and proliferation in distinct organs. Kounis syndrome is defined as the concurrence of acute coronary syndromes with mast cell activation in a setting of allergic or hypersensitivity reactions. This is the first reported case of an intraoperative Kounis syndrome as the onset of an indolent systemic mastocytosis probably triggered by succinylated gelatin infusion during general anesthesia. The presentation of this case is intended to contribute to the knowledge of mastocytosis and Kounis syndrome at the time of diagnostic workup during intraoperative anaphylaxis or myocardial ischemia.

  1. A new case of keratoconus associated with Williams-Beuren syndrome.

    PubMed

    Viana, Melissa Machado; Frasson, Maria; Leão, Letícia Lima; Stofanko, Martin; Gonçalves-Dornelas, Higgor; Cunha, Pricila da Silva; de Aguiar, Marcos José Burle

    2013-09-01

    Williams-Beuren syndrome is a multisystemic genetic disorder caused by a contiguous gene deletion at 7q11.23. Keratoconus is a complex disease and it is suspected to have a genetic origin, although the specific gene responsible for keratoconus has not been identified. Although there are several ocular features in Williams-Beuren syndrome, keratoconus is not regularly described as part of this syndrome. To report a new patient with keratoconus and Williams-Beuren syndrome. This is the third case of an association between Williams-Beuren syndrome and keratoconus. The authors believe that the Williams-Beuren syndrome chromosome region can be a possible target for further investigation as the genetic basis of keratoconus.

  2. Early diagnosis of Gorlin-Goltz syndrome: case report.

    PubMed

    Casaroto, Ana R; Loures, Daniela C N Rocha; Moreschi, Eduardo; Veltrini, Vanessa C; Trento, Cleverson L; Gottardo, Vilmar D; Lara, Vanessa S

    2011-01-25

    The Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS), is an infrequent multisystemic disease inherited in a dominant autosomal way, which shows a high level of penetrance and variable expressiveness. It is characterized by keratocystic odontogenic tumors (KCOT) in the jaw, multiple basal cell nevi carcinomas and skeletal abnormities. This syndrome may be diagnosed early by a dentist by routine radiographic exams in the first decade of life, since the KCOTs are usually one of the first manifestations of the syndrome. This article paper reports the case of a patient, a 10-year-old boy with NBCCS, emphasizing its clinical and radiographic manifestations. This study highlights the importance of health professionals in the early diagnosis of NBCCS and in a preventive multidisciplinary approach to provide a better prognosis for the patient.

  3. Neonatal marfan syndrome: report of two cases.

    PubMed

    Ghandi, Yazdan; Zanjani, Keyhan S; Mazhari-Mousavi, Seyed-Eshagh; Parvaneh, Nima

    2013-02-01

    Neonatal Marfan syndrome is a rare and severe phenotype of this disease. A poor prognosis is anticipated due to the high probability of congestive heart failure, and mitral and tricuspid regurgitations with suboptimal response to medical therapy and difficulties in surgical management at an early age. We present two consecutive patients with this disease who are the first reported cases from Iran to the best of our knowledge. Unfortunately both of them died shortly after diagnosis. Neonatal Marfan syndrome is reported from Iran and has a poor prognosis like the patients reported from elsewhere.

  4. Successful medical management of a case of Austrian syndrome-an uncommon entity in the modern antibiotic era: a case report.

    PubMed

    Rahim, Muhammad Abdur; Zaman, Shahana; Haque, Hasna Fahmima; Afroze, Samira Rahat; Uddin, Khwaja Nazim

    2017-09-06

    Austrian syndrome-the combination of meningitis, pneumonia and infective endocarditis due to Streptococcus pneumoniae infection, is a rare entity. In literature only a few hundreds of cases are reported but surprisingly we did not find any report on Austrian syndrome in or from Bangladesh. We report the case history of a middle aged Bangladeshi diabetic man, who had fever, cough, shortness of breath and altered mentation. He had tachycardia, bi-basal lung crepitations, new cardiac murmurs and meningism. Diagnostic work-up revealed Austrian syndrome. Because of the rarity of the condition, this case is reported. A case of pneumococcal pneumonia or meningitis should raise suspicion of concomitant endocarditis and Austrian syndrome, specially if there is heart failure, as early recognition and treatment may appear life-saving.

  5. Auto Indexer Auto-Indexer for Percussive Hammers: Vane Motor Dynamometer Testing

    DOE Data Explorer

    Su, Jiann

    2012-01-01

    Objectives Options associated with geothermal drilling operations are generally limited by factors such as formation temperature and rock strength. The objective of the research is to expand the "tool box" available to the geothermal driller by furthering the development of a high-temperature drilling motor that can be used in directional drilling applications for drilling high temperature geothermal formations. The motor is specifically designed to operate in conjunction with a pneumatic down-the-hole-hammer. It provides a more compact design compared to traditional drilling motors such as PDMs (positive displacement motors). The packaging can help to enhance directional drilling capabilities. It uses no elastomeric components, which enables it to operate in higher temperatures ( >250 °F). Current work on the motor has shown that is a capable of operating under pneumatic power with a down-the-hole-hammer. Further development work will include continued testing and refining motor components and evaluating motor capabilities. Targets/Milestones Complete testing current motor - 12/31/2010 Make final material and design decisions - 01/31/2011 Build and test final prototype - 04/31/2011 Final demonstration - 07/31/2011 Impacts The development of the motor will help to achieve program technical objectives by improving well construction capabilities. This includes enabling high-temperature drilling as well as enhancing directional drilling. A key component in the auto indexer is the drive motor. It is an air-driven vane motor that converts the energy stored in the compressed air to mechanical energy. The motor is attached to hammer-like components which impart an impulsive load onto the drive shaft. The impulsive force on the drive shaft in turn creates an indexing action. A controlled test was performed to characterize the performance of the the vane motor for a given pressure. The Sandia dynamometer test station was used to determine the performance of the motor for a

  6. [Congenital cardiopathy in a patient with Sotos syndrome. Description of a case].

    PubMed

    Di Marco, G; Levantesi, G; Parisi, G; Chiarelli, A

    1989-05-01

    The number of cases of Sotos syndrome or cerebral gigantism described in the literature total more than 200. For 6 of these, cardiac malformations were described. The authors report a case of Sotos syndrome in which malformative alterations of the aortic and mitral valves were simultaneously present.

  7. [H syndrome: First reported paediatric case in Latin America].

    PubMed

    Abarca Barriga, Hugo Hernán; Trubnykova, Milana; Polar Córdoba, Victoria; Ramos Diaz, Katherine Joyce; Aviles Alfaro, Nélida

    H Syndrome is an extremely rare genetic disease, with a multisystemic character and which can be identified in early childhood, offering the opportunity of specific treatment and genetic counselling. To present a clinical case with "typical" characteristics of H Syndrome. The case is presented of an 8-year-old male patient who presented with testicular tumours and skin lesions characterised by hyperpigmentation with hypertrichosis, language delay, short stature, and joint deformities. He also presented with bilateral sensorineural hearing loss, anaemia, hypergammaglobulinaemia, and bone disorders. Histopathology studies of the skin and testicular masses reported lymphoplasmacytic infiltration. Sequencing analysis of gene SLC29A3 showed the homozygote mutation c.1087 C>T (p.Arg363Trp; rs387907067). These findings are consistent with H syndrome, and this is the first reported case in Latin America. The key to the diagnosis is the finding of hyperpigmentation with hypertrichosis. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Kindler syndrome: a case report and proposal for clinical diagnostic criteria.

    PubMed

    Fischer, Irena Angelova; Kazandjieva, Jana; Vassileva, Snejina; Dourmishev, Assen

    2005-06-01

    Kindler syndrome is a rare hereditary disorder characterized by acral blister formation in infancy and childhood, progressive poikiloderma, cutaneous atrophy and increased photosensitivity. Since it was first described in 1954, less than 100 cases have been reported worldwide. Recently it has been reported that Kindler syndrome is the first genodermatosis caused by a defect in the actin-extracellular matrix linkage, and the gene was mapped to chromosome 20p12.3. The clinical features of the syndrome have been annotated by different authors but the definite of criteria to confirm the diagnosis have not yet been generally accepted. We report a case of Kindler syndrome that presents a full spectrum of clinical manifestations, and we propose a set of clinical criteria for diagnosis.

  9. Scalene Myofascial Pain Syndrome Mimicking Cervical Disc Prolapse: A Report of Two Cases

    PubMed Central

    Abd Jalil, Nizar; Awang, Mohammad Saufi; Omar, Mahamarowi

    2010-01-01

    Scalene myofascial pain syndrome is a regional pain syndrome wherein pain originates over the neck area and radiates down to the arm. This condition may present as primary or secondary to underlying cervical pathology. Although scalene myofascial pain syndrome is a well known medical entity, it is often misdiagnosed as being some other neck pain associated with radiculopathy, such as cervical disc prolapse, cervical spinal stenosis and thoracic outlet syndrome. Because scalene myofascial pain syndrome mimics cervical radiculopathy, this condition often leads to mismanagement, which can, in turn, result in persistent pain and suffering. In the worst-case scenarios, patients may be subjected to unjustifiable surgical intervention. Because the clinical findings in scalene myofascial pain syndrome are “pathognomonic”, clinicians should be aware of ways to recognize this disorder and be able to differentiate it from other conditions that present with neck pain and rediculopathy. We present two cases of unilateral scalene myofascial pain syndrome that significantly impaired the patients’ functioning and quality of life. This case report serves to create awareness about the existence of the syndrome and to highlight the potential morbidity due to clinical misdiagnosis. PMID:22135529

  10. Enamel renal syndrome with associated amelogenesis imperfecta, nephrolithiasis, and hypocitraturia: A case report.

    PubMed

    Bhesania, Dhvani; Arora, Ankit; Kapoor, Sonali

    2015-09-01

    Numerous cases of enamel renal syndrome have been previously reported. Various terms, such as enamel renal syndrome, amelogenesis imperfecta and gingival fibromatosis syndrome, and enamel-renal-gingival syndrome, have been used for patients presenting with the dental phenotype characteristic of this condition, nephrocalcinosis or nephrolithiasis, and gingival findings. This report describes a case of amelogenesis imperfecta of the enamel agenesis variety with nephrolithiasis in a 21-year-old male patient who complained of small teeth. The imaging modalities employed were conventional radiography, cone-beam computed tomography, and renal sonography. Such cases are first encountered by dentists, as other organ or metabolic diseases are generally hidden. Hence, cases of amelogenesis imperfecta should be subjected to advanced diagnostic modalities, incorporating both dental and medical criteria, in order to facilitate comprehensive long-term management.

  11. Portal hypertension as the initial manifestation of POEMS syndrome: a case report.

    PubMed

    Wu, Lina; Li, Yue; Yao, Fang; Lu, Chongmei; Li, Jian; Zhou, Weixun; Qian, Jiaming

    2017-01-01

    Portal hypertension has a broad differential diagnosis. POEMS syndrome is an uncommon cause of it. POEMS syndrome is a rare disease involving multiple organs. In differential diagnosis of portal hypertension, POEMS syndrome should be considered especially when other symptoms such as numbness, organomegaly, endocrine alteration and skin changes also present, as it is highlighted by our case. We report a 46-year-old Chinese male, a teacher, presenting with portal hypertension. Electromyography revealed peripheral neuropathy. Immunofixation showed monoclonal immunoglobulin A lambda protein. The diagnosis of POEMS syndrome was established. After treatment of lenalidomide combined with dexamethasone over 2 years, the patient achieved a considerable improvement. This case highlights the manifestation of portal hypertension in POEMS syndrome. Lenalidomide with or without dexamethasone is effective for portal hypertension due to POEMS syndrome, though esophageal and gastric varices seems not reversible so easily.

  12. Skull wounds linked with blunt trauma (hammer example). A report of two depressed skull fractures--elements of biomechanical explanation.

    PubMed

    Delannoy, Yann; Becart, Anne; Colard, Thomas; Delille, Rémi; Tournel, Gilles; Hedouin, Valéry; Gosset, Didier

    2012-09-01

    The lesions of the skull following perforating traumas can create complex fractures. The blunt traumas can, according to the swiftness and the shape of the object used, create a depressed fracture. The authors describe through two clinical cases the lesional characteristic of the blunt traumas, perforating the skull using a hammer. In both cases the cranial lesions were very typical: they were geometrical, square shaped, of the same size than the tool (head and tip of the hammer). On the outer table of the skull, the edges of the wounds were sharp and regular. On the inner table, the edges of the wounds were beveled and irregular. The bony penetration in the depressed fracture results from a rupture of the outer table of the bone under tension, in periphery, by the bend of the bone to the impact (outbending) and then, from the inner table with comminuted bony fragmentation. Breeding on the fractures of the size and the shape of the blunt objects used is inconstant and differs, that it is the objects of flat surface or wide in opposition to those of small surface area. Fractures morphologies depend on one hand on these extrinsic factors and on the other hand, of intrinsic factors (structure of the bone). To identify them, we had previously conducted experimental work on cranial bone samples. The bone was submitted to a device for three-point bending. This work had shown properties of thickness and stiffness of the various areas of the vault. Our cases are consistent with these results and illustrate the variability of bone lesions according to region and mode of use of blunt weapons. Many studies have identified criteria for identification of the weapons and the assistance of digital and biomechanical models will be an invaluable contribution with this aim in the future. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. A case of orbital apex syndrome due to Pseudomonas aeruginosa infection

    PubMed Central

    Kusunoki, Takeshi; Kase, Kaori; Ikeda, Katsuhisa

    2011-01-01

    Orbital apex syndrome is commonly been thought to have a poor prognosis. Many cases of this syndrome have been reported to be caused by paranasal sinus mycosis. We encountered a very rare case (60-year-old woman) of sinusitis with orbital apex syndrome due to Pseudomonas aeruginosa infection. She had received insulin and dialysis for diabtes and diabetic nephropathy, moreover anticoagulants after heart by-pass surgery. She underwent endoscopic sinus operation and was treated with antibiotics, but her loss of left vision did not improve. Recently, sinusitis cases due to Pseudomonas aeruginosa were reported to be a increasing. Therefore, we should consider the possibility of Pseudomonas aeruginosa as well as mycosis as infections of the sinus, especially inpatients who are immunocompromised body. PMID:24765368

  14. A case of orbital apex syndrome due to Pseudomonas aeruginosa infection.

    PubMed

    Kusunoki, Takeshi; Kase, Kaori; Ikeda, Katsuhisa

    2011-09-28

    Orbital apex syndrome is commonly been thought to have a poor prognosis. Many cases of this syndrome have been reported to be caused by paranasal sinus mycosis. We encountered a very rare case (60-year-old woman) of sinusitis with orbital apex syndrome due to Pseudomonas aeruginosa infection. She had received insulin and dialysis for diabtes and diabetic nephropathy, moreover anticoagulants after heart by-pass surgery. She underwent endoscopic sinus operation and was treated with antibiotics, but her loss of left vision did not improve. Recently, sinusitis cases due to Pseudomonas aeruginosa were reported to be a increasing. Therefore, we should consider the possibility of Pseudomonas aeruginosa as well as mycosis as infections of the sinus, especially inpatients who are immunocompromised body.

  15. The association between prune belly syndrome and dental anomalies: a case report.

    PubMed

    Basso, Maria Daniela; Favretto, Carla Oliveira; Cunha, Robson Frederico

    2012-12-18

    Prune belly syndrome is a rare condition produced by an early mesodermal defect that causes abdominal abnormalities. However, the literature indicates that disturbances related to ectodermal development may also be present. This is the first case report in the literature to suggest that dental abnormalities are part of the broad spectrum of clinical features of prune belly syndrome. Because the syndrome causes many serious medical problems, early diagnosis of abnormalities involving the primary and permanent dentitions are encouraged. The authors report the clinical case of a 4-year-old Caucasian boy with prune belly syndrome. In addition to the triad of abdominal muscle deficiency, abnormalities of the gastrointestinal and urinary tracts, and cryptorchidism, a geminated mandibular right central incisor, agenesis of a mandibular permanent left incisor, and congenitally missing primary teeth (namely, the mandibular right and left lateral incisors) were noted. This original case report about prune belly syndrome highlights the possibility that dental abnormalities are a part of the broad spectrum of clinical features of the syndrome. Therefore, an accurate intra-oral clinical examination and radiographic evaluation are required for patients with this syndrome in order to provide an early diagnosis of abnormalities involving the primary and permanent dentitions.

  16. Theoretical analysis and design of hydro-hammer with a jet actuator: An engineering application to improve the penetration rate of directional well drilling in hard rock formations.

    PubMed

    He, Jiang-Fu; Liang, Yun-Pei; Li, Li-Jia; Luo, Yong-Jiang

    2018-01-01

    Rapid horizontal directional well drilling in hard or fractured formations requires efficient drilling technology. The penetration rate of conventional hard rock drilling technology in horizontal directional well excavations is relatively low, resulting in multiple overgrinding of drill cuttings in bottom boreholes. Conventional drilling techniques with reamer or diamond drill bit face difficulties due to the long construction periods, low penetration rates, and high engineering costs in the directional well drilling of hard rock. To improve the impact energy and penetration rate of directional well drilling in hard formations, a new drilling system with a percussive and rotary drilling technology has been proposed, and a hydro-hammer with a jet actuator has also been theoretically designed on the basis of the impulse hydro-turbine pressure model. In addition, the performance parameters of the hydro-hammer with a jet actuator have been numerically and experimentally analyzed, and the influence of impact stroke and pumped flow rate on the motion velocity and impact energy of the hydro-hammer has been obtained. Moreover, the designed hydro-hammer with a jet actuator has been applied to hard rock drilling in a trenchless drilling program. The motion velocity of the hydro-hammer ranges from 1.2 m/s to 3.19 m/s with diverse flow rates and impact strokes, and the motion frequency ranges from 10 Hz to 22 Hz. Moreover, the maximum impact energy of the hydro-hammer is 407 J, and the pumped flow rate is 2.3 m3/min. Thus, the average penetration rate of the optimized hydro-hammer improves by over 30% compared to conventional directional drilling in hard rock formations.

  17. Theoretical analysis and design of hydro-hammer with a jet actuator: An engineering application to improve the penetration rate of directional well drilling in hard rock formations

    PubMed Central

    He, Jiang-fu; Li, Li-jia; Luo, Yong-jiang

    2018-01-01

    Rapid horizontal directional well drilling in hard or fractured formations requires efficient drilling technology. The penetration rate of conventional hard rock drilling technology in horizontal directional well excavations is relatively low, resulting in multiple overgrinding of drill cuttings in bottom boreholes. Conventional drilling techniques with reamer or diamond drill bit face difficulties due to the long construction periods, low penetration rates, and high engineering costs in the directional well drilling of hard rock. To improve the impact energy and penetration rate of directional well drilling in hard formations, a new drilling system with a percussive and rotary drilling technology has been proposed, and a hydro-hammer with a jet actuator has also been theoretically designed on the basis of the impulse hydro-turbine pressure model. In addition, the performance parameters of the hydro-hammer with a jet actuator have been numerically and experimentally analyzed, and the influence of impact stroke and pumped flow rate on the motion velocity and impact energy of the hydro-hammer has been obtained. Moreover, the designed hydro-hammer with a jet actuator has been applied to hard rock drilling in a trenchless drilling program. The motion velocity of the hydro-hammer ranges from 1.2 m/s to 3.19 m/s with diverse flow rates and impact strokes, and the motion frequency ranges from 10 Hz to 22 Hz. Moreover, the maximum impact energy of the hydro-hammer is 407 J, and the pumped flow rate is 2.3 m3/min. Thus, the average penetration rate of the optimized hydro-hammer improves by over 30% compared to conventional directional drilling in hard rock formations. PMID:29768421

  18. CFD simulation of reverse water-hammer induced by collapse of draft-tube cavity in a model pump-turbine during runaway process

    NASA Astrophysics Data System (ADS)

    Zhang, Xiaoxi; Cheng, Yongguang; Xia, Linsheng; Yang, Jiandong

    2016-11-01

    This paper reports the preliminary progress in the CFD simulation of the reverse water-hammer induced by the collapse of a draft-tube cavity in a model pump-turbine during the runaway process. Firstly, the Fluent customized 1D-3D coupling model for hydraulic transients and the Schnerr & Sauer cavitation model for cavity development are introduced. Then, the methods are validated by simulating the benchmark reverse water-hammer in a long pipe caused by a valve instant closure. The simulated head history at the valve agrees well with the measured data in literature. After that, the more complicated reverse water-hammer in the draft-tube of a runaway model pump-turbine, which is installed in a model pumped-storage power plant, is simulated. The dynamic processes of a vapor cavity, from generation, expansion, shrink to collapse, are shown. After the cavity collapsed, a sudden increase of pressure can be evidently observed. The process is featured by a locally expending and collapsing vapor cavity that is around the runner cone, which is different from the conventional recognition of violent water- column separation. This work reveals the possibility for simulating the reverse water-hammer phenomenon in turbines by 3D CFD.

  19. Metachronous Uterine Endometrioid Adenocarcinoma and Peritoneal Mesothelioma in Lynch Syndrome: A Case Report.

    PubMed

    Lu, Yuxin; Milchgrub, Sara; Khatri, Gaurav; Gopal, Purva

    2017-05-01

    Lynch syndrome is a hereditary disease with germline mutation in a DNA mismatch repair gene, most often presenting with colorectal and/or endometrial carcinomas; however, the spectrum of Lynch syndrome-associated tumors is expanding. In this article, we report a case of a primary peritoneal epithelioid mesothelioma that developed in a Lynch syndrome patient 10 months after diagnosis of uterine endometrioid adenocarcinoma. To our knowledge, this is the first reported case of a Lynch syndrome patient with metachronous uterine endometrioid adenocarcinoma and primary peritoneal mesothelioma.

  20. [Trisomy 18 syndrome: A case report].

    PubMed

    Saldarriaga, Wilmar; Rengifo-Miranda, Heidy; Ramírez-Cheyne, Julián

    2016-01-01

    The trisomy 18 syndrome occurs due to the presence of an extra chromosome 18 in most cases. The prevalence in infants is estimated at 1:6000 to 1:8000. Those affected have a high mortality rate, only 4% may survive their first year of life. There are few reported cases exceeding five years of age. The aim of this paper is to report a case of trisomy 18 of long survival with oral cavity features not described in the literature, and to provide information to physicians and paediatricians about aetiology, phenotype, survival and genetic counselling. A 7 year-old female patient with 2 karyotypes performed by lymphocyte culture showing 47XX+18 in all metaphases. She presented with growth deficiency, dysmorphic facies, severe psychomotor retardation and cognitive disability, inability to feed, lack of verbal language, sensorineural hearing loss, ataxia, cerebellar hypoplasia, and genitals with hypoplastic labia majora and minora. In the oral cavity: dome shaped palate, macroglossia, absence of upper central incisors and first upper and lower molars in mouth. X-ray findings showed formation of missing teeth, with late eruption being concluded. In cases of trisomy 18 syndrome there is an increased risk of neonatal and infant mortality. The clinical characteristics in utero and in neonates have been well described. Since few cases exceeding five years of age have been reported, the phenotype is yet to be established. In the case being reported we describe oral cavity findings not documented in the literature. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Pigmentary retinopathy due to Bardet-Biedl syndrome: case report and literature review.

    PubMed

    Andrade, Luis Jesuino de Oliveira; Andrade, Rafael; França, Caroline Santos; Bittencourt, Alcina Vinhaes

    2009-01-01

    Bardet-Biedl syndrome (BBS) is a rare autosomal recessive disorder with clinical and genetic heterogeneity. This syndrome was first described by Laurence and Moon in 1866 and additional cases were described by Bardet and Biedl between 1920 and 1922. The main features are obesity, polydactyly, pigmentary retinopathy, learning disabilities, various degrees of intellectual impairment, hypogonadism, and renal abnormalities. Bardet-Biedl syndrome is both phenotypically and genetically heterogeneous. Clinical diagnosis is based on the presence of 4 of the 5 cardinal features. The authors present a typical case of pigmentary retinopathy due to Bardet-Biedl syndrome and made a brief commentary about the disease's cardinal manifestations.

  2. Dual intersection syndrome of the forearm: a case report

    PubMed Central

    Zhari, Bouchra; Edderai, Meryem; Boumdine, Hassan; Amil, Touriya; En-nouali, Hassan

    2015-01-01

    The intersection syndrome, described since the 19th century, is an uncommon disorder associated with rubbing at the crossing point between the first dorsal compartment muscles and the radial wrist extensor muscles. Imaging modalities used to diagnosis this syndrome includes ultrasonography and magnetic resonance imaging. We reported a case of a 60-year-old man presented to our formation with painful swelling on the dorsum of the wrist and forearm. An MRI and an ultrasound were performed, and objectified a dual cross syndrome of the forearm. PMID:26587172

  3. A case-control evaluation of fungiform papillae density in burning mouth syndrome.

    PubMed

    Naud, Jason M; Benca, Laura; Drangsholt, Mark T; LeResche, Linda; Coldwell, Susan E

    2018-04-01

    It has been hypothesized that high fungiform papillae density may be a risk factor for developing the taste and pain alterations characteristic of burning mouth syndrome. Evaluate whether fungiform papillae density, taste sensitivity, and mechanical pain sensitivity differ between burning mouth syndrome cases and controls. This case-control study compared cases diagnosed with primary burning mouth syndrome with pain-free controls. Participants (17 female cases and 23 female controls) rated the intensity of sucrose, sodium chloride, citric acid, and quinine applied separately to each side of the anterior tongue and sampled whole mouth. Mechanical pain sensitivity was assessed separately for each side of the tongue using weighted pins. Digital photographs of participants' tongues were used to count fungiform papillae. Burning mouth syndrome cases had increased whole mouth taste intensity. Cases also had increased sensitivity to quinine on the anterior tongue, as well as increased mechanical pain sensitivity on the anterior tongue. Fungiform papillae density did not differ significantly between cases and controls. Fungiform papillae density on the left and right sides of the tongue were correlated in controls; however, there was no left/right side correlation in cases. Cases had increased pain and taste perception on the anterior tongue. The lack of correlation between left and right fungiform papillae density in cases may be an indication of asymmetrical lingual innervation in these patients. 3b. Laryngoscope, 128:841-846, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  4. [Chronicle myeloid leukemia and hiperviscosity syndrome: case report].

    PubMed

    Amâncio, Juliana; Scuro, Gisele; Gazoni, Fernanda Martins; Guimarães, Hélio Penna; Vendrame, Letícia Sandre; Lopes, Renato Delascio; Lopes, Antônio Carlos

    2008-03-01

    Hyperleukocytosis (> 100 x 10(9)/L) is an uncommon presentation of chronic leukemias and it can present clinical symptoms of hyperviscosity syndrome. Hearing loss and blindness rarely occurs in patients with leukemia; however, it can be strong association with hyper-viscosity syndrome. The purpose of this paper is to report a case of acute hearing loss as the initial manifestation of acute leukemia and hyper-viscosity syndrome and also mainly aspects of the intensive care treatment. A 41 year-old, male patient, who has been complaining about dizziness for six months with no response to symptomatic medications, was admitted to the emergency department with acute hearing loss. The physical examination was normal except for a bilateral hearing loss without an apparent cause. Laboratory exams showed total leukocyte: 645.000 with 66.4% blasts, hemoglobin: 7.0, hematocrit: 20.5, urea: 94, creatinine: 1.59, K: 5.6, Na: 138, INR: 1.38, TTPa: 0.89, troponin lower than 0.2, CK: 218, CKMB: 50, uric acid: 11.1. After a first hypothesis of leukemia with a high risk of hyper-viscosity complications, the patient was admitted to the Intensive Care Unit for monitoring and treatment. A bone marrow biopsy was performed and than started hidratation, hydroxyurea, allopurinol, dexamethasone. According to hematologists the patient had a chronic myeloid leukemia. Leukopheresis was performed one week after admission when total blood leukocytes were around 488.000. Ten days after the procedure the patient had no improvement of the hearing loss but total leukocytes were 10.100. He was discharge to the ward and 2 weeks later went home to continue ambulatory treatment. The frequency of sensitive manifestations in patients with leukemia include not only visual and hearing loss but also many others manifestations such as conductive vertigo, facial palsy and infections. Hyperviscosity syndrome due to hyperleukocytosis is also a possible cause of sensorial loss, but the syndrome is often dependent

  5. Gilles de la Tourette's syndrome in a patient with 47(XXX) syndrome: a case report.

    PubMed

    Chiappedi, Matteo; de Vincenzi, Silvia; Dolci, Roberta; De Luca, Sara; Bejor, Maurizio

    2011-11-05

    To the best of our knowledge, this is the first report of a comorbidity between Gilles de la Tourette's syndrome and 47 (XXX) syndrome. The clinical picture of Gilles de la Tourette's Syndrome is well described, while 47 (XXX) syndrome is much more rare and has a broader spectrum of possible phenotypic presentations. An Italian Caucasian girl was referred at the age of 11 to our Rehabilitation Center for anxiety and learning difficulties. The girl had already been diagnosed as having 47(XXX) syndrome; she had some rather typical features of the chromosomal abnormality, but she also showed a high level of anxiety and the presence of motor and vocal tics. When an accurate history was taken, a diagnosis of Gilles de la Tourette's Syndrome emerged. The possible interaction between peculiar features of these two syndromes in terms of neuropsychological and affective functioning is both interesting for the specific case and to hypothesize models of rehabilitation for patients with one or both syndromes. Executive functions are specifically reduced in both syndromes, therefore it might be hard to discriminate the contribution of each one to the general impairment; the same applies to anxiety. Moreover, mental retardation (with a significantly lower verbal cognitive functioning) poses relevant problems when suggesting cognitive behavioral or psychoeducational rehabilitative approaches.

  6. Platypnea-orthodeoxia syndrome in the right lateral decubitus position: a case report.

    PubMed

    Tsuzuki, Ippei; Iigaya, Kamon; Matsubara, Takashi; Takagi, Shunsuke; Inohara, Taku; Ohgino, Yasuyuki; Imafuku, Toshio

    2017-04-12

    Platypnea-orthodeoxia syndrome is a rare syndrome characterized by dyspnea and hypoxia when the patient is sitting or standing. Here we report a case of platypnea-orthodeoxia syndrome caused by a right hemidiaphragmatic elevation with giant liver cyst that triggered a right-to-left shunt through the patent foramen ovale. This case report is the first presentation of a case secondary to hemidiaphragmatic elevation with giant liver cyst. In addition to this, a malposition of the pacemaker lead could be associated with platypnea-orthodeoxia syndrome in this case. A 91-year-old Japanese woman presented to our hospital with hypoxia of unknown origin. Severe hypoxia and cyanosis were observed only in the right lateral decubitus position. A chest X-ray and computed tomography scan revealed right hemidiaphragmatic elevation, which was probably compressing the right atrium. A transesophageal echocardiogram showed a compressed right atrium and shunt blood flow in both directions: from the left to the right atrium and vice versa. The shunt flow was exacerbated by postural changes from the left to the right lateral decubitus. A transesophageal echocardiogram also confirmed compression of the right atrium due to giant liver cyst and a malposition of the pacemaker lead abnormally placed in the left atrium through patent foramen ovale. We concluded that the cause of hypoxia was platypnea-orthodeoxia syndrome with right-to-left interatrial shunt through patent foramen ovale. Surgical closure of patent foramen ovale was not performed due to the age of our patient, surgical difficulties, and failure to obtain informed consent. For these reasons she was discharged after receiving medical advice about her posture. Platypnea-orthodeoxia syndrome is rare and difficult to diagnose. The present case suggests that hypoxia due to postural changes should be considered a differential diagnosis of platypnea-orthodeoxia syndrome.

  7. Concurrent insulinoma with mosaic Turner syndrome: A case report.

    PubMed

    Wang, Shaoyun; Yang, Lijuan; Li, Jie; Mu, Yiming

    2015-03-01

    Turner syndrome is a chromosomal abnormality in which the majority of patients have a 45XO karyotype, while a small number have a 45XO/47XXX karyotype. Congenital adrenal hyperplasia has been previously reported in patients with Turner syndrome. Although insulinomas are the most common type of functioning pancreatic neuroendocrine tumor and have been reported in patients with multiple endocrine neoplasias, the tumors have not been reported in patients with mosaic Turner syndrome. The present study reports the first case of an insulinoma in a patient with 45XO/47XXX mosaic Turner syndrome. The patient suffered from recurrent hypoglycemia, which was relieved following ingestion of glucose or food. A 5-h glucose tolerance test was performed and the levels of glucose, C-Peptide and insulin were detected. In addition, computed tomography (CT) and ultrasound scanning were performed to evaluate the possibility of an insulinoma. Pathological examination and karyotyping were performed on a surgical specimen and a whole blood sample, respectively. The patient was found to suffer from premature ovarian failure, and a physical examination was consistent with a diagnosis of Turner syndrome. An ultrasound scan demonstrated streak ovaries and the patient was found to have a 45XO/47XXX karyotype. Furthermore, a lesion was detected in the pancreas following CT scanning, which was identified as an insulinoma following surgical removal and histological examination. In conclusion, the present study reports the first case of an insulinoma in a patient with mosaic Turner syndrome. Since mosaic Turner syndrome and insulinoma are rare diseases, an association may exist that has not been previously identified.

  8. Mazabraud syndrome associated with McCune-Albright syndrome: a case report and review of the literature.

    PubMed

    Biazzo, Alessio; Di Bernardo, Andrea; Parafioriti, Antonina; Confalonieri, Norberto

    2017-08-23

    Mazabraud syndrome is a very rare benign disorder characterized by the association of monostotic or polyostotic fibrous dysplasia and one or multiple intramuscular myxomas. McCune -Albright syndrome is a rare benign disorder characterized by the association of polyostotic fibrous dysplasia, cafè-au-lait skin pigmentations and endocrine dysfunction, such as precocious puberty, diabetes mellitus, goiter and breast fibroadenomatosis. The association of Mazabraud syndrome and McCune-Albright in the same patient is an anecdotal event. We report the case of a 28-year-old girl with Mazabraud syndrome associated with McCune-Albright syndrome. Our literature review shows that in these patients there is a higher risk of malignant transformation of fibrous dysplasia into osteosarcoma, confirming previous reports. Conversely, no malignant transformation has been reported for myxomas in isolated Mazabraud syndrome or in the association with McCune-Albright syndrome. We conclude that these patients should be scheduled to a close and long-term follow-up.

  9. Multiple abdominal cysts in a patient with Gorlin-Goltz syndrome: a case report.

    PubMed

    Haenen, F; Hubens, G; Creytens, D; Vaneerdeweg, W

    2013-01-01

    A rare case of symptomatic mesenteric cysts in a patient with Gorlin-Goltz syndrome, associated with various neoplasms, is presented. The patient, known with Gorlin-Goltz syndrome, consulted with increasingly severe abdominal pain and large abdominal cysts. At surgery, the cysts were excised and the postoperative course was uneventful. In conclusion, this case reminds clinicians to always maintain a wide differential diagnosis when dealing with patients known with Gorlin-Goltz syndrome.

  10. Scoliosis in Steinert syndrome: a case report.

    PubMed

    Themistocleous, George S; Sapkas, George S; Papagelopoulos, Panayiotis J; Stilianessi, Eugenia V; Papadopoulos, Elias Ch; Apostolou, Constantinos D

    2005-01-01

    Steinert syndrome is described as an autosomal dominant condition characterized by progressive muscular wasting, myotonia, musculoskeletal manifestations and rare spinal defects. Little is reported about spinal deformity associated with this syndrome. We present a patient with Steinert syndrome complicated by scoliosis. In the literature on muscular dystrophy, other than Duchenne, little mention is given to the problem of scoliosis in general and its treatment in particular. A case report of a patient with Steinert syndrome associated with thoracic scoliosis and hypokyphosis is presented. A 17-year-old boy presented with King type II right thoracic scoliosis (T5-T11, Cobb angle of 40 degrees) and hypokyphosis--10 degrees. He was treated with posterior stabilization and instrumentation at level T3-L2 with a postoperative correction of the scoliotic curve to 20 degrees. Histopathologic examination of the muscles confirmed the diagnosis of Steinert myotonic dystrophy. At 30-month follow-up, the patient was clinically pain free and well balanced. Plain radiographs showed solid spine fusion with no loss of deformity correction. Scoliosis in Steinert syndrome shares the characteristic of an arthrogrypotic neuromuscular curve and demands the extensive soft tissue release for optimal surgical correction. Intraoperative observations included profound tissue bleeding, abnormally tough soft tissues and a difficult recovery from anaesthesia.

  11. Ectopic Cushing syndrome: Report of 9 cases.

    PubMed

    Araujo Castro, Marta; Palacios García, Nuria; Aller Pardo, Javier; Izquierdo Alvarez, Cristina; Armengod Grao, Laura; Estrada García, Javier

    2018-05-01

    Ectopic Cushing's syndrome (ECS) is a rare condition caused by ACTH secretion by extrapituitary tumors. Its low frequency makes it difficult to acquire experience in its management. The aim of this study was to describe patients with ECS seen at the endocrinology department of a tertiary hospital over 15 years. This was a retrospective study of the clinical, biochemical and radiographic data, treatment, and course of patients with ECS seen from 2000 to 2015. Nine patients (6 of them female) with a mean age of 47 years were included in the study. The clinical syndrome developed in less than 3 months in all cases but one, and most patients also had edema, hyperpigmentation and/or hypokalemia. Mean urinary free cortisol and ACTH levels were 2,840μg/24h and 204pg/mL respectively. The ectopic origin was confirmed by a combination of dynamic non-invasive tests and radiographic studies in most cases. The tumor responsible could be identified in 8 cases, and 7 patients had metastatic dissemination. Primary treatment was surgery in one patient, surgery combined with systemic therapy in 3, and chemotherapy in the other 3 patients. Bilateral adrenalectomy was required in 4 patients to control hypercortisolism. After a mean follow-up of 40 months, 3 patients died, 5 were still alive, and one had been lost to follow-up. Our study confirms that ECS covers a wide spectrum of tumors of different aggressiveness and nature. The ectopic origin of Cushing's syndrome can usually, be suspected and confirmed in most cases without the need for invasive tests. Control of both hypercortisolism and the tumor requires multiple treatment modalities, and multidisciplinary management is recommended. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. The Effect of Venue and Wind on the Distance of a Hammer Throw

    ERIC Educational Resources Information Center

    Hunter, Iain

    2005-01-01

    In track and field, gravity and air resistance act on the hammer after it has been released. Both of these forces depend on altitude and latitude. In addition, air resistance also depends on wind, temperature, humidity, and barometric pressure. Often, air resistance and varying gravity throughout the earth are not considered when throwing…

  13. Antithyroid Arthritis Syndrome: A Case Report and Review of the Literature

    PubMed Central

    Takaya, Kazuhiko; Kimura, Natsumi; Hiyoshi, Toru

    2016-01-01

    We herein report the case of a 38-year-old Japanese woman with antithyroid arthritis syndrome who experienced severe migratory polyarthritis after the initiation of thiamazole therapy. The patient's symptoms promptly disappeared without any sequelae after the withdrawal of the drug. Antithyroid arthritis syndrome is poorly characterized, and the findings from our literature review indicate that this syndrome exhibits serological features that are distinct from those of antithyroid agent-induced vasculitis syndrome. The absence of autoantibodies, especially anti-neutrophil cytoplasmic antibodies, may help characterize and diagnose antithyroid arthritis syndrome. Furthermore, physicians' awareness of this syndrome is essential for its diagnosis in clinical practice. PMID:27980264

  14. Non-Hodgkin's lymphoma in McKusick syndrome. A case report.

    PubMed

    Torkzad, M R; Hjalmar, V; Blomqvist, L

    2002-07-01

    The McKusick syndrome in a female who developed highly malignant lymphoma at the age of 23, with multiple parenchymal lesions involving both kidneys, the lungs and the pancreas and also splenomegaly but without lymphadenopathy, is described together with diagnostic imaging findings. McKusick syndrome is associated with impaired cell-mediated immunity and might, like several other similar syndromes, harbor an increased risk of certain types of lymphoma. To our knowledge, there are no previous reports of non-Hodgkin's lymphoma in a patient with McKusick syndrome. The increased incidence of lymphoma in certain cases of congenital immunodeficiency raises the issue of a possible relationship between McKusick syndrome and lymphoma and could perhaps serve as one of the primary steps for a further characterization of this syndrome.

  15. Waardenburg Syndrome: A Case Study of Two Patients.

    PubMed

    Sharma, Karan; Arora, Archana

    2015-09-01

    Waardenburg syndrome is an autosomal dominant disorder with an incidence of 1 in 40,000 that manifests with sensorineural deafness, pigmentation defects of the skin, hair and iris and various defects of neural crest-derived tissues. This genetically heterogeneous disease accounts for >2 % of the congenitally deaf population. Mutations in the EDN3, EDNRB, MITF, PAX3, SNAI2, and SOX10 genes can cause Waardenburg syndrome. We here report a case of 12 year old female who presented with chief complaint of decreased hearing in both ears and had clinical features consistent with Waardenburg syndrome. She had a distinct white forelock of hair in the midline along with striking bilateral blue iris. Also a white depigmented patch was present on the right forearm. Both eyes had bright red fundal reflex with choroidal depigmentation. Her younger brother, the second case in this study, had similar blue eyes, white forelock of hair, depigmented skin patch and choroidal depigmentation but with normal hearing. Their father had a history of premature graying of hair. All the primary care physicians coming across a child with blue eyes and white forelock of hair should get the child's hearing tested at the first instance, if not already tested. An early diagnosis and improvement of hearing impairment with timely intervention are the most important for psychological and intellectual development of children with Waardenburg syndrome.

  16. An Interesting Case of Tolosa-Hunt Syndrome in a Young Male.

    PubMed

    Murtaza, Ghulam; Konowitz, Nicholas; Lu, Hannah; Faqah, Anadil; Kuruvilla, Aneesh

    2017-01-01

    Tolosa-Hunt syndrome is a rare disease with a limited number of cases reported in the literature. It typically presents with orbital pain associated with palsy of the third, fourth, or sixth cranial nerve. We present an interesting case of Tolosa-Hunt syndrome in a young male who responded well to high-dose steroids and in a few days had significant improvement in his retro-orbital pain and ocular movements.

  17. An unusual case of KBG syndrome with unique oral findings

    PubMed Central

    Hafiz, Abdul; Mufeed, Abdulla; Ismael, Mohamad; Alam, Mheboob

    2015-01-01

    KBG syndrome is a condition characterised by macrodontia, neurological disturbance, short stature, a distinct cranio-facial appearance, and skeletal anomalies. The authors describe what appears to be the first case of KBG syndrome reported from the Indian subcontinent. Meticulous evaluation of the dental findings helps to identify such cases which may otherwise remain undiagnosed. Further research is warranted to determine the classic and variant presentations of this condition, with follow-up data providing valuable insights into its natural history and long-term prognosis. PMID:26187867

  18. Goldston syndrome in a fetus: case report and literature review.

    PubMed

    Avcu, Serhat; Akdeniz, Hüseyin; Unal, Ozkan; Kurdoğlu, Mertihan

    2010-01-01

    We present a case of the Goldston syndrome which is the association of polycystic kidneys with Dandy-Walker malformation. The diagnosis was made by ultrasound in twenty second week of gestation. Obstetric ultrasound and fetal MRI studies showed hydrocephalus, agenesis of the cerebellar hemispheres, vermian hypoplasia, cystic dilatation of the 4(th) ventricle, enlargement of the posterior fossa, abdominal distension, and oligohydramnios.. The kidneys were symmetrically enlarged and multicystic. To our knowledge this is the third reported case of Goldston syndrome which was diagnosed during intrauterine life.

  19. Down Syndrome and Fragile X Syndrome in a Colombian Woman: Case Report.

    PubMed

    Saldarriaga, Wilmar; Ruiz, Fabian Andres; Tassone, Flora; Hagerman, Randi

    2017-09-01

    Down syndrome (DS) and Fragile X syndrome (FXS) are the major genetic causes of intellectual disabilities. Here, we present a case of a 32-year-old woman with the diagnosis of both FXS and DS. She is the daughter of a 47-year-old pre-mutation woman who also has three sons with FXS. Cytogenetic testing detected the presence of a complete trisomy 21. A combination of PCR and Southern blot analysis was utilized to document the presence of the FMR1 full mutation. The patient has physical characteristics and behavioural disturbances typical of both FXS and DS, which were confirmed by molecular testing. Her treatment plan included a trial of sertraline because of the severity of her shyness and lack of language. She had an excellent response to sertraline with improvement in shyness and social interactions, particularly with family members. In this study, we report the case of a woman with both FXS and DS, which is the fifth case of FXS and DS in the world's literature. The patient is from Ricaurte, a small town in Colombia, South America, where there is the world's highest prevalence for FXS. © 2016 John Wiley & Sons Ltd.

  20. Placental expression of anti-angiogenic proteins in mirror syndrome: a case report.

    PubMed

    Graham, N; Garrod, A; Bullen, P; Heazell, A E P

    2012-06-01

    Mirror syndrome is a rare disorder in which fetal hydrops is associated with maternal oedema, proteinuria and hypertension. The aetiology of the maternal condition is unknown, but it is thought to be related to preeclampsia. Few descriptions exist of placental morphology in mirror syndrome, but placentomegaly is consistently observed. In this case placental morphology showed villous oedema and syncytial nuclear aggregates where villi were in direct contact. Immunoperoxidase staining for VEGFR1 and Endoglin was more intense in mirror syndrome compared to gestational-age matched controls,and at a similar level to a case of preeclampsia. Placentally-derived anti-angiogenic factors may be involved in the pathogenesis of mirror syndrome. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Case report: Guillain-Barre syndrome with pneumococcus - A new association in pediatrics.

    PubMed

    Khatib, Hassan El; Naous, Amal; Ghanem, Soha; Dbaibo, Ghassan; Rajab, Mariam

    2018-01-01

    Guillain-Barre Syndrome, an acute flaccid paralysis known to be caused by recent Gastro-intestinal infections mainly campylobacter, and Respiratory infections mainly mycoplasma pneumoniae and influenza. One reported case of severe invasive pneumococcal disease in a 68 year old female, that presented with Austrian's triad of meningitis, pneumonia and endocarditis, and progressed to develop Guillain Barre syndrome, an association never been documented before. We present a case of 13 year old male, presented with hypoactivity and inability to bare his own weight, developed septic shock due to pneumococcus with Acute Respiratory Distress Syndrome, and was found to have neurological findings of Guillain-Barre Syndrome. A new association in pediatric age group, never been reported before.

  2. Gorlin-Goltz Syndrome: Case report and literature review

    PubMed Central

    Ramesh, Maya; Krishnan, Ramesh; Chalakkal, Paul; Paul, George

    2015-01-01

    Gorlin-Goltz syndrome (GGS) is an infrequent multisystemic disease with an autosomal dominant trait, with complete penetrance and variable expressivity, though sporadic cases have been described. This article includes a case report and an extensive review of the GGS with regard to its history, incidence, etiology, features, investigations, diagnostic criteria, keratocystic odontogenic tumor and treatment modalities. PMID:26604511

  3. Gorlin-Goltz Syndrome: Case report and literature review.

    PubMed

    Ramesh, Maya; Krishnan, Ramesh; Chalakkal, Paul; Paul, George

    2015-01-01

    Gorlin-Goltz syndrome (GGS) is an infrequent multisystemic disease with an autosomal dominant trait, with complete penetrance and variable expressivity, though sporadic cases have been described. This article includes a case report and an extensive review of the GGS with regard to its history, incidence, etiology, features, investigations, diagnostic criteria, keratocystic odontogenic tumor and treatment modalities.

  4. Susac syndrome: the first case report in Peru.

    PubMed

    Rivadeneira-Sotelo, Carolina; Meza Vega, María; Segura-Chávez, Darwin; Castro-Suarez, Sheila

    2017-08-30

    Susac Syndrome is a rare entity, characterized by a triad of subacute encephalopathy, retinal artery occlusion and sensorineural hearing loss. It is more common in women and the age of onset fluctuates between 9-58 years of age. The pathogenesis is presented as microangiopathic changes at the cerebral, retinal and cochlear levels associated with an autoimmune mechanism. We present the case of a 31-year-old woman who started with a diffuse headache, puerile behavior, bradylalia and somnolence. As the disease progressed, she had auditory deficit and arterial obstruction of the right temporal retinal branch in retinal fluorescein angiography. Brain magnetic resonance showed rounded hyperintense lesions in the corpus callosum, periventricular region and cerebellum. This is the first reported case of Susac Syndrome in Peru, presented with the classic triad, which is an infrequent presentation. However, cases that show incomplete forms should be evaluated in a timely manner to initiate timely treatment and avoid irreversible consequences.

  5. [Larsen syndrome: two reports of cases with spinal cord compromise].

    PubMed

    Martín Fernández-Mayoralas, D; Fernández-Jaén, A; Muñoz-Jareño, N; Calleja-Pérez, B; San Antonio-Arce, V; Martínez-Boniche, H

    Larsen syndrome is characterised by untreatable congenital dislocation of multiple body joints, along with marked foot deformities. These patients have a flattened face with a short nose, a broad depressed nasal bridge and a prominent forehead. In this clinical note our aim is to report two cases that coursed with spinal cord compromise. Case 1: an 18-month-old female with congenital dislocation of knees and hips. The patient had a flat face, sunken root of nose, and carp mouth. Magnetic resonance imaging of the spine showed severe cervical kyphosis secondary to malformation and hypoplasia of the cervical vertebral bodies and important compression of the spinal cord. Clinically, there were also signs of upper motor neuron syndrome, which was especially prominent in the lower limbs. Case 2: a 14-year-old male with a characteristic face and dislocation of the head of the radius. The patient presented amyotrophy of the muscles in the right hand and clinical signs of lower motor neuron syndrome due to neuronal damage secondary to spinal malformations. Larsen syndrome is an infrequent osteochondrodysplasia. Alteration of the spine is common and may give rise to spinal cord compression with varying clinical repercussions which require surgical treatment in the early years of the patient's life.

  6. [Hellp syndrome. Presentation of a case and review of the literature].

    PubMed

    Vargas Hernández, V M; Romo Vázquez, L M; Oros Ramírez, J A

    1991-07-01

    A severe case of preeclampsia with Hellp Syndrome is reported. Clinical findings, laboratory abnormalities and pathogenesis, were discussed. We concluded that severe preeclampsia and Hellp Syndrome are not different diseases, but the natural course of preeclampsia per se.

  7. Generalized epilepsy in a patient with mosaic Turner syndrome: a case report.

    PubMed

    Jhang, Kai-Ming; Chang, Tung-Ming; Chen, Ming; Liu, Chin-San

    2014-04-02

    Reports on cases of epilepsy in Turner syndrome are rare and most of them have cortical developmental malformations. We report the case of a Taiwanese patient with mosaic Turner syndrome with generalized tonic-clonic epilepsy and asymmetrical lateral ventricles but no apparent cortical anomaly. A 49-year-old Taiwanese woman without family history presented with infrequent generalized tonic-clonic epilepsy since she was 11 years old. On examination, her short stature, webbed neck, swelling of hands and feet, retrognathic face, and mild intellectual disability were noted. She had spontaneous menarche and regular menses. Brain magnetic resonance imaging showed asymmetrical lateral ventricles and diffuse subcortical white matter T2-weighted hyperintensities. Chromosome studies disclosed low aneuploid (10%) 45,X/46,XX/47,XXX mosaic Turner syndrome. There is increasing evidence that epilepsy can be an uncommon presentation of Turner syndrome. Mosaic Turner syndrome with 47, XXX probably increases the risk of epilepsy but more research is needed to reach a conclusion. This case also strengthens our knowledge that Turner syndrome can be one of the pathologic bases of asymmetrical lateral ventricles. When a patient has idiopathic/cryptogenic epilepsy or asymmetrical lateral ventricles on brain images, the presence of a mild Turner phenotype warrants further chromosome studies.

  8. A case of melanocytic cervical adenosquamous carcinoma complicated with Cushing's syndrome.

    PubMed

    Chen, Y; Zhang, Y; Wang, L; Yang, X

    2017-01-01

    To date, cervical carcinoma complicated with Cushing's syndrome were all diagnosed as small cell carcinoma histo- logically, but not adenosquamous carcinoma. Here the authors present the diagnosis, management, and prognosis of a case of melanocytic cervical adenosquamous carcinoma complicated with Cushing's syndrome. A 28-year-old woman was admitted with the chief complaint of post-coital bleeding for one month. Gynecological examination revealed a nodular yellowish-pigmented vegetation (6x5 cm) on the cervix. Laboratory findings proved the diagnosis of Cushing's syndrome. Histopathological diagnosis showed the adenosquamous carcinoma with melanoma differentiation. Immunohistochemical stainings for melanoma A and anti- adrenocorticotropic hormone (ACTH) were positive in the majority of the tumor cells, which indicated that this melanocytic cervical carcinoma lesion was the source of ectopic ACTH production resulting in Cushing's syndrome. This is a unique case of a rare type of cervical carcinoma.

  9. Axenfeld-Rieger syndrome (ARS): A review and case report.

    PubMed

    Waldron, Jennie M; McNamara, Clare; Hewson, Antonia R; McNamara, C M

    2010-01-01

    Axenfeld-Rieger syndrome (ARS) is a rare, autosomal dominant condition characterized by ocular, craniofacial, dental, and periumbilical abnormalities. Relatively little information exists on this syndrome within the dental literature despite the fact that midface hypoplasia and maxillary hypodontia are classical presenting features of this syndrome. This is a case report of a 7-year-old Caucasian female with ARS who presented with significant ocular and dental anomalies. She was also found to have osteopenia. Her dental condition is described, her immediate treatment is shown, and her long-term treatment needs are discussed. ©2010 Special Care Dentistry Association and Wiley Periodicals, Inc.

  10. A case of refeeding syndrome in a marine recruit.

    PubMed

    Bunge, Paul D; Frank, Laura L

    2013-04-01

    Refeeding syndrome is an under-recognized complication of starvation. Presented is a 26-year-old Marine recruit who was found to have hypothermia, mental status changes, and rhabdomyolysis after purposeful weight loss with calorie restriction in conjunction with an arduous exercise program. With rest and food, the patient developed refeeding syndrome, with hypophosphatemia requiring prolonged intravenous replacement. His case is unique in illustrating both malnutrition and refeeding syndrome in someone who appeared to be healthy and was exercising strenuously up to the point of hospital admission. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  11. [Wernicke-Korsakoff syndrome secondary to cytomegalovirus encephalitis: A case report].

    PubMed

    Uribe, Luis Guillermo; Pérez, María Alejandra; Lara, Camilo Andrés; Rueda, Natalia; Hernández, Javier Augusto

    2017-12-01

    Cytomegalovirus (CMV) is one of the opportunistic microorganisms with the highest prevalence in immunocompromised patients. Reactivation has decreased after the introduction of highly active antiretroviral therapy (HAART). Encephalitis has been reported in the coinfection as one of the most frequent presentations.We present the case of a young adult patient with HIV infection and rapid neurological deterioration due to classic clinical symptoms and signs of the Wernicke-Korsakoff syndrome, with no risk factors for thiamine deficiency, with images by nuclear magnetic resonance typical of the syndrome, and identification of cytomegalovirus in cerebrospinal fluid. The specific treatment for CMV managed to control the symptoms with neurological sequelae in progression towards improvement.This is one of the few cases reported in the literature of Wernicke syndrome secondary to cytomegalovirus encephalitis.

  12. Research on the water hammer protection of the long distance water supply project with the combined action of the air vessel and over-pressure relief valve

    NASA Astrophysics Data System (ADS)

    Li, D. D.; Jiang, J.; Zhao, Z.; Yi, W. S.; Lan, G.

    2013-12-01

    We take a concrete pumping station as an example in this paper. Through the calculation of water hammer protection with a specific pumping station water supply project, and the analysis of the principle, mathematical models and boundary conditions of air vessel and over-pressure relief valve we show that the air vessel can protect the water conveyance system and reduce the transient pressure damage due to various causes. Over-pressure relief valve can effectively reduce the water hammer because the water column re-bridge suddenly stops the pump and prevents pipeline burst. The paper indicates that the combination set of air vessel and over-pressure relief valve can greatly reduce the quantity of the air valve and can eliminate the water hammer phenomenon in the pipeline system due to the vaporization and water column separation and re-bridge. The conclusion could provide a reference for the water hammer protection of long-distance water supply system.

  13. Laugier-Hunziker syndrome: A case report.

    PubMed

    Wei, Z; Li, G-Y; Ruan, H-H; Zhang, L; Wang, W-M; Wang, X

    2018-04-01

    Laugier-Hunziker syndrome (LHS) is a rare, benign, acquired pigmentary condition mainly affecting lips, oral mucosa and acral area, frequently associated with longitudinal melanonychia. Herein, we reported a 45-year-old female case with LHS. The clinical, dermoscopic, histopathologic features of LHS were reviewed and the important differential diagnosis was discussed. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  14. Gestational Diabetes Insipidus Associated with HELLP Syndrome: A Case Report

    PubMed Central

    Gambito, Renela; Chan, Michael; Sheta, Mohamed; Ramirez-Arao, Precious; Gurm, Harmeet; Tunkel, Allan; Nivera, Noel

    2012-01-01

    Gestational diabetes insipidus is a rare, but well recognized, complication of pregnancy. It is related to excess vasopressinase enzyme activity which is metabolized in the liver. A high index of suspicion of gestational diabetes insipidus is required in a correct clinical setting especially in the presence of other risk factors such as preeclampsia, HELLP syndrome, and twin pregnancies. We are presenting a case of gestational diabetes insipidus in a patient with HELLP syndrome. The newborn in this case also had hypernatremia thereby raising possibilities of vasopressinase crossing the placenta. PMID:24555139

  15. A unique case of Shwachman-Diamond syndrome presenting with congenital hypopituitarism.

    PubMed

    Jivani, Nurin; Torrado-Jule, Carmen; Vaiselbuh, Sarah; Romanos-Sirakis, Eleny

    2016-11-01

    Shwachman-Diamond syndrome (SDS) is an autosomal recessive bone marrow failure syndrome typically characterized by neutropenia and pancreatic dysfunction, although phenotypic presentations vary, and the endocrine phenotype is not well-described. We report a unique case of a patient with SDS who initially presented with hypoglycemia and micropenis in the newborn period and was diagnosed with congenital hypopituitarism. We are not aware of any other cases of SDS documented with this combination of complex endocrinopathies.

  16. A case of the corpus callosum and alien hand syndrome from a discrete paracallosal lesion.

    PubMed

    Faber, Raymond; Azad, Alvi; Reinsvold, Richard

    2010-08-01

    Here we present a patient with an isolated paracallosal brain lesion who exhibited behavioral changes associated with the corpus callosum syndrome (CCS) including features of the alien hand syndrome (AHS). The CCS is also known as the split-brain syndrome, the syndrome of hemisphere disconnection, the syndrome of brain bisection and the syndrome of the cerebral commissures. Because most reported cases of CCS were caused by tumors which extended beyond the corpus callosum (CC) and did not always induce a complete disconnection, there was much controversy about the role of the CC and the existence of a specific CCS. Aside from surgically based cases, the full complement of the CCS is infrequently clinically encountered. The patient described has a classic CCS from natural causes. This case report is unique in exhibiting a complete CCS with AHS secondary to an ischemic event affecting the left pericallosal region. To our knowledge this is the first case report of such a combination.

  17. Anesthetic management of Shah–Waardenburg syndrome: Experience of two cases and review of literature

    PubMed Central

    Ambi, Uday S.; Adarsh, E. S.; Hatti, Ramesh; Samalad, Vijaymahantesh

    2012-01-01

    Waardenburg syndrome (WS) is a rare autosomally inherited and genetically heterogeneous disorder of neural crest cell development. Literature regarding the anesthetic management of these cases is limited. We present 2 cases of Shah–Waardenburg syndrome and discuss them in the context of review of previously published cases. PMID:22754447

  18. A Case of Churg-Strauss Syndrome Associated with Antiphospholipid Antibodies

    PubMed Central

    Ferenczi, Katalin; Chang, Timothy; Camouse, Melissa; Han, Rujing; Stern, Robert; Willis, Joseph; Cooper, Kevin D.; Gilliam, Anita C.

    2008-01-01

    BACKGROUND Churg-Strauss syndrome (CSS) is a systemic vasculitis affecting small and medium-sized blood vessels, almost invariably affecting the lung and frequently associated with cutaneous involvement. Microvascular vaso-occlusion leading to digital gangrene is not a feature of CSS. OBSERVATIONS We report an unusual case of a patient with Churg Strauss Syndrome with antiphospholipid antibodies who developed severe digital gangrene in addition to cutaneous vasculitis. CONCLUSION The presence of antiphospholipid antibodies is not a feature usually seen in association with Churg-Strauss syndrome. While the full clinical spectrum of Churg Strauss Syndrome is still being defined, identification of additional features associated with this syndrome might help to better understand the pathogenesis of the disease and to have an impact on management and prognosis. PMID:17175066

  19. A Case of Loeffler's Endocarditis Associated with Churg-Strauss Syndrome

    PubMed Central

    Seo, Jeong-Sook; Kim, Dae-Hee; Kang, Duk-Hyun; Song, Jae-Kwan

    2010-01-01

    Loeffler's endocarditis is generally caused by hypereosinophilic syndrome. It is a restrictive cardiomyopathy characterized with eosinophilia and eosionophilic penetration leading to the fibrous thickening of endocardium of both ventricles, apical obliteration and heart failure. We report a case of a 23-year-old male with Loeffler's endocarditis caused by Churg-Strauss syndrome. The echocardiogram showed that biventricular failure with large thrombus in left ventricle. His symptoms and typical echocardiographic findings markedly improved within 2 months after treatment for Churg-Strauss syndrome. PMID:20661332

  20. Fetal urine biochemistry in antenatal Bartter syndrome: a case report.

    PubMed

    Rachid, Myriam L; Dreux, Sophie; Czerkiewicz, Isabelle; Deschênes, Georges; Vargas-Poussou, Rosa; Mahieu-Caputo, Dominique; Oury, Jean-François; Muller, Françoise

    2016-09-01

    Bartter syndrome is a severe inherited tubulopathy responsible for renal salt wasting, and hence electrolyte disorders and dehydration. Prenatally, it is characterized by severe polyhydramnios caused by fetal polyuria. We studied for the first time fetal urine in a Bartter syndrome case and demonstrated that the tubulopathy is already present at 24 weeks of gestation.

  1. Painful legs and moving toes syndrome: a 76-patient case series.

    PubMed

    Hassan, Anhar; Mateen, Farrah J; Coon, Elizabeth A; Ahlskog, J Eric

    2012-08-01

    To better characterize the clinical features, electrophysiologic features, and treatment outcomes of painful legs and moving toes (PLMT) syndrome. Large case series. Neurology outpatient clinic at a tertiary referral center, 1983-2011. All cases of PLMT seen at our institution during an 18-year period were identified using our medical record linkage system. Key demographic, clinical, imaging, and electrophysiologic features of PLMT. Treatment outcomes and long-term follow-up are also reported. Of 76 cases identified (including 50 women [66%]), the mean age at onset was 58 years (range, 24-86 years) and at neurologic evaluation was 63 years (range, 26-88 years). Pure lower limb involvement was most common (69 patients [91%]), and 44 cases (58%) were bilateral. The most frequently diagnosed causes were peripheral neuropathy (21 cases [28%]), previous trauma (8 [11%]), and radiculopathy (7 [9%]); 32 cases (42%) were cryptogenic. Electromyography consistently showed irregular 50-millisecond to 1-second bursts of normal motor unit potential firing at 2 to 200 Hz accompanying the movements. Pain occurred first in nearly all cases and was more distressing to patients than the movements. Both components were difficult to treat, with no consistent benefit from a variety of drugs and therapeutic modalities. The syndrome persisted in most patients (83%) during the mean follow-up of 4.6 years, suggesting low likelihood of spontaneous resolution. Painful legs and moving toes syndrome is a debilitating clinical syndrome, not because of the movements but rather because of the pain, which often is refractory to treatment. Segmental lower limb involvement is most common, and neurophysiologic findings support a pathophysiologic process localizing to a central generator at the spinal cord or brainstem level.

  2. [Adam hammer (1818 - 1878) - remarks on a forgotten pioneer of ether anaesthesia in obstetrics].

    PubMed

    Goerig, M; Streckfuss, W

    2004-05-01

    Adam Hammer, born in 1818, and working as a doctor for the poor since 1847 in Mannheim, was the first person in the German speaking world to use ether for pain relief during labor on February 18th 1847. He took part in the abortive April 1848 Revolution in Mannheim - a pinnacle of German liberalism and later of political radicalism, which attented to abolish the Monarchy and introduce a democratic Republic. After the revolution was put down, Hammer emigrated to the United States and settled down in St. Louis, Missouri. Remaining politically active, he joined the Republican Party, founded in 1854 and served as a military surgeon in the Union Army during the American Civil War. Even before the war, he was engaged in efforts to improve the level of medical training in America and was involved with the foundation of High Schools which offered training courses along the lines of German universities. His ideas and innovations were not introduced immediately, but had a significant impact on medical training methology later on in the US. During a visit in Europe in 1876, he was the first to diagnose a coronary thombosis as the cause of a heart attack on a live patient. The diagnosis was later confirmed by post-morten autopsy on the patient. In 1877 he returned to Germany and died one year later. The biography of Adam Hammer mirrows that of many other German-Americans whose emigration proved to be a gain for America but a loss for Germany. This story was destinated to be repeated in terrible circumstances some decades later.

  3. Anesthetic management of an obstetric patient with MELAS syndrome: case report and literature review.

    PubMed

    Maurtua, M; Torres, A; Ibarra, V; DeBoer, G; Dolak, J

    2008-10-01

    Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS syndrome) is a mitochondrial disorder associated with neurologic, cardiac, neuromuscular, hepatic, metabolic and gastrointestinal dysfunction and potential anesthetic and obstetric complications. The case of a parturient with MELAS syndrome requiring labor analgesia is presented. A Medline literature search limited to the English language was undertaken to review cases of MELAS syndrome. Based on our experience and literature review, parturients with MELAS syndrome appear to benefit from neuraxial analgesia and anesthesia, which blunt excessive oxygen consumption and acidosis.

  4. [Use of bevacizumab (Avastin) in KID syndrome: case report].

    PubMed

    Caye, Luiza; Scheid, Karin; Pizzol, Melissa Manfroi Dal; Freda, Roberto

    2010-01-01

    KID syndrome is a congenital ectodermal dysplasia characterized by the association of keratitis, hyperkeratotic skin lesions and neurosensorial hearing loss. Ocular involvement occurs in 95% of patients. Although KID syndrome cutaneous manifestations have been studied in-depth, the treatment and prognosis of ophthalmic impairment have not been described in detail. At present, the treatment of the ocular damage caused by the syndrome is symptomatic and there are no studies defining a treatment that could change the disease course. In this case, ophthalmologic findings of a patient with KID syndrome and the use of subconjunctival bevacizumab to treat corneal neovascularization are described. In spite of the absence of improvement in this patient and the few reports of this disease, additional studies with bevacizumab to treat corneal deep neovascularization are suggested.

  5. Fat embolism syndrome following percutaneous vertebroplasty: a case report.

    PubMed

    Ahmadzai, Hasib; Campbell, Scott; Archis, Constantine; Clark, William A

    2014-04-01

    Vertebroplasty is commonly performed for management of pain associated with vertebral compression fractures. There have been two previous reports of fatal fat embolism following vertebroplasty. Here we describe a case of fat embolism syndrome following this procedure, and also provide fluoroscopic video evidence consistent with this occurrence. The purpose of this study was to review the literature and report a case of fat embolism syndrome in a patient who underwent percutaneous vertebroplasty for compression fracture. The study design for this manuscript was of a clinical case report. A 68-year-old woman who developed sudden back pain with minimal trauma was found to have a T6 vertebral compression fracture on radiographs and bone scans. Percutaneous vertebroplasty of T5 and T6 was performed. Fluoroscopic imaging during the procedure demonstrated compression and rarefaction of the fractured vertebra associated with changes in intrathoracic pressure. Immediately after the procedure, the patient's back pain resolved and she was discharged home. Two days later, she developed increasing respiratory distress, confusion, and chest pain. A petechial rash on her upper arms also appeared. No evidence of bone cement leakage or pulmonary filling defects were seen on computed tomography-pulmonary angiography. Brain magnetic resonance imaging demonstrated hyperintensities in the periventricular and subcortical white matter on T2/fluid-attenuated inversion recovery sequences. A diagnosis of fat embolism syndrome was made, and the patient recovered with conservative management. Percutaneous vertebroplasty is a relatively safe and simple procedure, reducing pain and improving functional limitations in patients with vertebral fractures. This case demonstrates an uncommon yet serious complication of fat embolism syndrome. Clinicians must be aware of this complication when explaining the procedure to patients and provide prompt supportive care when it does occur. Copyright © 2014

  6. Bilateral silent sinus syndrome: A rare case and review of literature.

    PubMed

    Trope, Michal; Schwartz, Joseph S; Tajudeen, Bobby A; Kennedy, David W

    2017-06-01

    In this report, we presented a rare case of bilateral silent sinus syndrome (SSS) in an otherwise healthy 57-year-old man treated with functional endoscopic sinus surgery (FESS). A systematic review of the literature regarding bilateral SSS was performed. A 57-year-old man with well-controlled allergic rhinitis in the absence of previous surgery or trauma presented with bilateral SSS, which was successfully managed with bilateral FESS. A medical literature data base search of the terms "silent sinus syndrome" "maxillary atelectasis," "imploding antrum syndrome," and "bilateral silent sinus syndrome" was performed. The results were then narrowed to include only relevant articles. Relevant articles included three case reports and two articles that describe or mention bilateral SSS. Of the three case reports found, two patients presented with bilateral SSS, whereas the third patient presented metachronously, with the contralateral SSS manifesting 4 months after presentation of the initial ipsilateral SSS. The present literature regarding bilateral SSS is likely incomplete, and further investigation is required to provide greater insight into the prevalence of this disease. In this report, bilateral FESS was successful in resolving symptoms and preventing disease progression.

  7. [Fournier syndrome: report of a clinical case].

    PubMed

    La Torre, F; Otti, M; Ruggeri, E; Taglienti, D; Bonanno, L; Bianchini, G P; Veneroso, S; Tintisona, O; Monti, M

    2001-01-01

    The case of a Fournier's syndrome in a 58 years old patient is reported from the Authors that describe the ethiopathogenetic and therapeutic aspects. They analyse the importance of an early surgical treatment associated with antibiotic therapy and later a riparation of the lesions with a myocutaneous skin flap of TLF.

  8. [Nevoid basal-cell carcinoma syndrome (Gorlin Syndrome): report of two cases and review of the literature].

    PubMed

    Castro-Mujica, María Del Carmen; Barletta-Carrillo, Claudia; Poterico, Julio A; Acosta, Marisa; Valer, Jesús; Cruz, Miguel De La

    2017-01-01

    Gorlin syndrome (GS) is a genetic disorder with an autosomal dominant inheritance pattern, with complete penetrance and variable expressivity. GS is caused by germline mutations in the genes PTCH1 or SUFU, which are components of the Sonic hedgehog molecular pathway. GS is characterized by the presence of multiple nevoid basal cell carcinomas, odontogenic cysts, calcification of the brain sickle, and lesions in the palms and soles. This study is the first to report cases in Peru of patients with GS who underwent genetic evaluation and counseling. We present two GS cases that meet the clinical criteria for the syndrome and review the literature.

  9. 3-M syndrome: a report of three Egyptian cases with review of the literature.

    PubMed

    Temtamy, Samia A; Aglan, Mona S; Ashour, Adel M; Ramzy, Magda I; Hosny, Laila A; Mostafa, Mostafa I

    2006-04-01

    The 3-M syndrome is a rare autosomal recessive disorder. It is characterized by prenatal and postnatal growth retardation associated with characteristic features. In this study, we report on three patients from two unrelated families, including two male sibs, with the characteristic features and radiological findings of the 3-M syndrome. The main features in our cases were low birth weight, short stature, malar hypoplasia, anteverted nostrils with a fleshy nasal tip, long philtrum, pointed full chin, short broad neck, broad chest with transverse grooves of anterior thorax and hyperlordosis. An orodental examination revealed characteristic findings, some of which were not reported before. Prominent premaxilla, hypoplastic maxilla, thick patulous lips, high-arched palate, median fissured tongue, delayed eruption of teeth with enamel hypocalcification and malocclusion were present in our three studied cases. Radiographic studies showed slender long bones and ribs, a narrow pelvis and foreshortened vertebral bodies. Our reported cases are the offspring of healthy consanguineous parents, confirming the autosomal recessive pattern of inheritance in the syndrome. Cases were reported from different countries all over the world. To our knowledge, these are the first reported Egyptian patients with this rare disorder. This syndrome may be underreported because of the phenotypic overlap with other low birth dwarfism syndromes. Recent identification of a gene mutated in some cases of 3-M syndrome will aid diagnosis.

  10. Use of Hemadsorption in a Case of Pediatric Toxic Shock Syndrome.

    PubMed

    Berkes, Andrea; Szikszay, Edit; Kappelmayer, János; Kerényi, Adrienne; Szabó, Tamás; Ujhelyi, László; Bari, Krisztina; Balla, György; Balla, József

    2017-01-01

    Toxic shock syndrome is a potentially fatal toxin-mediated disease. The role of toxins in this clinical entity made us hypothesize that extracorporeal blood purification with CytoSorb® could play a beneficial role in the clinical management of toxic shock syndrome. This case report describes the successful treatment of toxic shock syndrome using a combination of renal replacement therapy and hemadsorption in a pediatric patient. A 5-year-old girl with Down's syndrome presented with an inflamed area surrounding an insect bite, signs of systemic inflammation, and multiple organ failure. As previous attempts of immune modulation therapy were unsuccessful, renal replacement therapy was supplemented by the cytokine absorber CytoSorb. Treatment using this combination was associated with a rapid and significant stabilization in the hemodynamic situation and a decrease in inflammatory mediators within hours after the initiation of therapy. The application of CytoSorb therapy was simple and safe. The use of extracorporeal blood purification with CytoSorb proved potentially beneficial by removing toxins and inflammatory mediators in this case and could therefore play a role in the clinical management of toxic shock syndrome. Whether CytoSorb has the potential to even positively influence mortality in patients with toxic shock syndrome still needs to be confirmed.

  11. Habitat for Humanity Project Hammers Home the Importance of Volunteerism | Frederick National Laboratory for Cancer Research

    Cancer.gov

    BRUNSWICK, Md. -- The staccato sounds of hammers and nail guns replaced the typical morning silence of a recent sunny Saturday in Brunswick, Md., where Frederick National Laboratory volunteers, their guests, and staff from Habitat for Humanity of Fre

  12. Expanding the phenotype of alopecia-contractures-dwarfism mental retardation syndrome (ACD syndrome): description of an additional case and review of the literature.

    PubMed

    Schell-Apacik, Chayim; Hardt, Michael; Ertl-Wagner, Birgit; Klopocki, Eva; Möhrenschlager, Matthias; Heinrich, Uwe; von Voss, Hubertus

    2008-09-01

    Alopecia-contractures-dwarfism mental retardation syndrome (ACD syndrome; OMIM 203550) is a very rare genetic disorder with distinct features. To our knowledge, there have been four cases documented to date. In addition, another three patients, previously described as having IFAP syndrome (OMIM %308205), may also have ACD syndrome. We report on one patient with short stature, total alopecia, ichthyosis, photophobia, seizures, ectrodactyly, vertebral anomalies, scoliosis, multiple contractures, mental retardation, and striking facial and other features (e.g. microdolichocephaly, missing eyebrows and eyelashes, long nose, large ears) consistent with ACD syndrome. Results of laboratory testing in the literature case reports were normal, although in none of them, array-CGH (microarray-based comparative genomic hybridization) analysis was performed. In conclusion, the combination of specific features, including total alopecia, ichthyosis, mental retardation, and skeletal anomalies are suggestive of ACD syndrome. We propose that children with this syndrome undergo a certain social pediatric protocol including EEG diagnostics, ophthalmological investigation, psychological testing, management of dermatologic and orthopedic problems, and genetic counseling.

  13. SHOX duplications found in some cases with type I Mayer-Rokitansky-Kuster-Hauser syndrome.

    PubMed

    Gervasini, Cristina; Grati, Francesca Romana; Lalatta, Faustina; Tabano, Silvia; Gentilin, Barbara; Colapietro, Patrizia; De Toffol, Simona; Frontino, Giada; Motta, Francesca; Maitz, Silvia; Bernardini, Laura; Dallapiccola, Bruno; Fedele, Luigi; Larizza, Lidia; Miozzo, Monica

    2010-10-01

    The Mayer-Rokitansky-Küster-Hauser syndrome is defined as congenital aplasia of müllerian ducts derived structures in females with a normal female chromosomal and gonadal sex. Most cases with Mayer-Rokitansky-Küster-Hauser syndrome are sporadic, although familial cases have been reported. The genetic basis of Mayer-Rokitansky-Küster-Hauser syndrome is largely unknown and seems heterogeneous, and a small number of cases were found to have mutations in the WNT4 gene. The aim of this study was to identify possible recurrent submicroscopic imbalances in a cohort of familial and sporadic cases with Mayer-Rokitansky-Küster-Hauser syndrome. Multiplex ligation-dependent probe amplification was used to screen the subtelomeric sequences of all chromosomes in 30 patients with Mayer-Rokitansky-Küster-Hauser syndrome (sporadic, n = 27 and familial, n = 3). Segregation analysis and pyrosequencing were applied to validate the MLPA results in the informative family. Partial duplication of the Xpter pseudoautosomal region 1 containing the short stature homeobox (SHOX) gene was detected in five patients with Mayer-Rokitansky-Küster-Hauser syndrome (familial, n = 3 and sporadic, n = 2) and not in 53 healthy controls. The duplications were not overlapping, and SHOX was never entirely duplicated. Haplotyping in the informative family revealed that SHOX gene duplication was inherited from the unaffected father and was absent in two healthy sisters. Partial duplication of SHOX gene is found in some cases with both familial and sporadic Mayer-Rokitansky-Küster-Hauser type I syndrome.

  14. Oculomotor apraxia and dilated cardiomyopathy with ataxia syndrome: A case report.

    PubMed

    Benson, Matthew D; Ferreira, Patrick; MacDonald, Ian M

    2017-01-01

    Dilated cardiomyopathy with ataxia syndrome (DCMA) is a rare mitochondrial condition associated with early onset cardiomyopathy and non-progressive ataxia. The cardiac manifestations may be progressive and often severe, resulting in significant morbidity and mortality. While optic nerve atrophy has been described in patients with DCMA, to our knowledge, there have been no reports of additional ocular phenotypes. We present two related Dariusleut Hutterite patients with documented DCMA syndrome and disorders of ocular motility: poor smooth pursuit and difficulty initiating saccadic eye movements and maintaining target fixation. We thus report the first cases of oculomotor apraxia in DCMA syndrome. By identifying these associated findings early in life, we hope to improve both the clinical diagnostic accuracy and timeliness of intervention in cases of DCMA.

  15. Naegeli-Franceschetti-Jadassohn syndrome: A rare case.

    PubMed

    Shah, Bela J; Jagati, Ashish K; Gupta, Neha P; Dhamale, Suyog S

    2015-01-01

    Naegeli-Franceschetti-Jadassohn Syndrome (NFJS) is a rare, autosomal dominant inherited form of ectodermal dysplasia, caused by mutation in the KRT14 gene. We report here a case of NFJS in a 27-year-old male who presented with reticulate hyperpigmentation over skin, dental changes, absence of dermatoglyphics, hypohidrosis, and hair changes.

  16. [A new case of Rowell's syndrome].

    PubMed

    Schissler, C; Banea, S; Tortel, M-C; Mahé, A

    2017-04-01

    This article introduces a new case of Rowell's syndrome, a controversial entity defined by the association of lupus erythematosus and erythema multiforme. A 43-year-old woman was diagnosed with lupus erythematosus induced by esomeprazole. Because her eruption did not improve after withdrawal of the drug, hydroxychloroquine was administered. Two weeks later, the patient described new annular lesions on her chest and arms, both erosive and crusted, and some had a target-like appearance. The oral mucosa was also affected. Histology revealed sub-epidermal blistering with keratinocytic necrosis, strongly suggesting erythema multiforme. Screening for other causes of erythema multiforme proved negative. A positive outcome was achieved with corticosteroids and hydroxychloroquine. One year later, the patient was in complete remission for both lupus erythematosus and erythema multiforme. The association of lupus erythematosus and erythema multiforme first described in 1963 is known as Rowell's syndrome. While diagnostic criteria have been established in the literature, the reality of this entity is still contested. The annular lesions of subacute lupus erythematosus may be confused with the lesions of erythema multiforme. As suggested in the above section, other authors consider Rowell's syndrome to be a singular entity. Indeed, our patient developed lesions distinct from those initially suggesting subacute lupus erythematosus, in particular: the target-like aspect of the elementary lesions, mucosal involvement, a distinct histological aspect, and dissociated outcomes. Ultimately, the definition of Rowell's syndrome remains highly debated. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. [Mayer-Rokitansky-Küster-Hauser syndrome: two cases report].

    PubMed

    Ávila-Vergara, Marco Antonio; León-Álvarez, Damián Alfredo; López-Villegas, Miriam Nayeli; Quintero-Medrano, Samantha Melissa; Angulo-Bueno, Gladys Fabiola; Vadillo-Ortega, Felipe

    2015-03-01

    Agenesia of the Müllerian ducts is a low-frequency congenital disease but with devastating effects on women's reproductive health. In this paper we present two cases of women affected by Mayer-Rokitansky-Küster-Hauser syndrome (MRKH). First case was a 17-year-old woman with aplasia of the upper vagina and absence of uterus. No other defects were found and was classified as type 1-MRKH. Second case was 18-year-old woman with absence of uterus, escoliosis and polycystic ovary syndrome, classified as type II-MRKH. Patients were seen at the Hospital with primary amenorrhea and fully developed secondary sexual characteristics. A clinical follow-up protocol, including the use of high-resolution image studies was used for diagnosis. Diagnostic procedures and current medical approaches to the treatment of MRKH are discussed, including psychological advisory, surgical procedures and new tissue-engineering techniques.

  18. Mesenteric vein thrombosis associated with Klinefelters syndrome--a case report.

    PubMed

    Murray, F E

    1988-01-01

    A case of mesenteric vein thrombosis presenting as gastrointestinal hemorrhage in a patient with Klinefelter's syndrome is reported, an association not previously described. The diagnosis was made preoperatively and was confirmed by angiography. The patient underwent a small bowel resection and made an uneventful recovery. A possible association between Klinefelter's syndrome and a hypercoagulable state, previously suggested elsewhere, is emphasized.

  19. [Acute Stress and Broken Heart Syndrome. A Case Report].

    PubMed

    Vergel, Juliana; Tamayo-Orozco, Sebastián; Vallejo-Gómez, Andrés Felipe; Posada, María Teresa; Restrepo, Diana

    Stress has been associated with an acute heart failure syndrome of important morbidity and mortality. Case report and non-systematic review of the relevant literature. A 65-year-old woman with a history of an untreated generalized anxiety disorder, whom after the violent death of her son presented with oppressive chest pain irradiated to neck and left superior extremity, lasting for more than 30minutes, initial clinical suspect suggests acute coronary syndrome. Tako-tsubo cardiomyopathy is characterized by a reversible left ventricular dysfunction and wall movement abnormalities, without any compromise of the coronary arteries, associated to high plasma levels of catecholamines which in most cases correlates with an acute stress of emotional or physical type. Tako-tsubo cardiomyopathy has to be considered by physicians among the differential diagnosis when facing a patient with suspected acute coronary syndrome, especially in post-menopausal women with a history of psychiatric comorbidities such as a generalized anxiety disorder. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  20. Acral peeling skin syndrome in two East-African siblings: case report

    PubMed Central

    2012-01-01

    Background Acral peeling skin syndrome is a rare autosomal recessive genodermatosis due to a missense mutation in transglutaminase 5. The skin peeling occurs at the separation of the stratum corneum from the stratum granulosum. Case presentation We present a case of two siblings who developed continuous peeling of the palms and soles from the first year of life. This peeling was more severe on the soles than palms and on younger sibling than elder sibling. Peeling is worsened by occlusion and sweating. Conclusions Sporadic cases of Acral Peeling Skin Syndrome occur in African population. There is variability in time of presentation and clinical severity even within families. PMID:22429841

  1. A case of acute confusion: Cushing's syndrome presenting with primary hyperparathyroidism.

    PubMed

    Irvine, Esmee; Yap, Yew Wen; Purewal, Tej; Irvine, Esmee

    2017-06-30

    Cushing's syndrome is a rare disease. Cushing's syndrome presenting as acute psychosis is an exceptional occurrence. We present the case of a 37-year-old woman who was admitted with acute confusion associated with mild hypercalcaemia and was subsequently diagnosed with parathyroid and adrenal adenomas. Our hospital sees approximately 6000 endocrine patients per year, with an incidence of around four Cushing's cases annually. This is the first such case to occur in our hospital and one of few described in the literature. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Mycoplasmataceae Colonizations in Women With Urethral Pain Syndrome: A Case-Control Study.

    PubMed

    Kyndel, Anna; Elmér, Caroline; Källman, Owe; Altman, Daniel

    2016-07-01

    To determine if Mycoplasma genitalium, Ureaplasma urealyticum, and Ureaplasma parvum are more common in premenopausal women with urethral pain syndrome than in asymptomatic controls. We used a case-control study design to compare the prevalence of M. genitalium, U. urealyticum, and U. parvum using polymerase chain reaction (PCR) analysis in urine. Urethral pain syndrome was defined as localized urethral pain with or without accompanying lower urinary tract symptoms during the past month or longer and at least one negative urine culture. Among the 28 cases, 46% carried Ureaplasma species compared with 64% of the 92 controls overall (P = 0.09). There were no significant differences in the prevalence of U. parvum and U. urealyticum among controls than in patients with urethral pain syndrome (P = 0.35 and P = 0.33, respectively). Co-colonization with U. parvum and urealyticum was infrequent, and there was only one case of M. genitalium colonization, which occurred among the controls. The symptomatic profile of Ureaplasma carriers with urethral pain syndrome was heterogeneous with no clear pattern and did not differ significantly compared with patients negative for Ureaplasma. We found no evidence to support the notion that M. genitalium, U. parvum, and U. urealyticum are more prevalent in women with urethral pain syndrome than in women without lower urinary tract symptoms.

  3. Like Father, Like Daughter-inherited cutis aplasia occurring in a family with Marfan syndrome: a case report.

    PubMed

    Islam, Yasmin Florence Khodeja; Williams, Charles A; Schoch, Jennifer Jane; Andrews, Israel David

    2017-01-01

    We present the case of a newborn with co-occurrence of Marfan syndrome and aplasia cutis congenita (ACC) and a family history significant for Marfan syndrome and ACC in the father. This case details a previously unreported mutation in Marfan syndrome and describes a novel coinheritance of Marfan syndrome and ACC.

  4. [Bowen's disease and squamous cell carcinoma in Haber's syndrome: two cases].

    PubMed

    Legoupil, D; Lemasson, G; Davaine, A-C; Misery, L

    2007-01-01

    Haber's syndrome is a rare form of autosomal dominant genodermatosis. Clinically, it is associated with rosaceiform dermatosis of the face that begins in childhood, and profuse keratotic lesions resembling seborrheic keratoses, seen predominantly on the trunk, the tops of the limbs and the scalp. We report two cases of Bowen's disease and cutaneous epidermoid carcinoma in Haber's syndrome patients. A 67 year-old woman with Haber's syndrome and with a familial history consulted for a budding lesion on the abdomen, histological examination of which confirmed epidermoid carcinoma. A 77 year-old woman presented a clinical picture consistent with Haber's syndrome, with three infiltrated erythematosquamous abdominal lesions. Histological examination of a biopsy sample confirmed the clinical diagnosis of Bowen's disease. The patient was successfully treated with imiquimod. These two cases appear to indicate the existence of an association between Haber's syndrome and the presence of cutaneous carcinomatous lesions. We propose the hypothesis of transformation of the keratoses seen in seborrheic keratosis. These lesions may be considered as pre-cancerous. Association with skin carcinomas requires regular monitoring of these patients. The use of imiquimod to treat lesions in patients with Bowen's disease resulted in complete cure.

  5. Cerebral venous thrombosis and secondary polycythemia in a case of nephrotic syndrome.

    PubMed

    Nagaraju, Shankar Prasad; Bairy, Manohar; Attur, Ravindra Prabhu; Sambhaji, Charudutt Jayant

    2016-03-01

    Cerebral venous thrombosis (CVT) and polycythemia are considered as rare and life threatening complications of nephrotic syndrome. We report an unusual combination of both these complications in a case of nephrotic syndrome due to minimal change disease that was treated successfully. There was prompt and complete remission of nephrotic syndrome with steroid therapy, concurrent with complete resolution of polycythemia and CVT.

  6. Cotard's syndrome: Two case reports and a brief review of literature.

    PubMed

    Grover, Sandeep; Aneja, Jitender; Mahajan, Sonali; Varma, Sannidhya

    2014-11-01

    Cotard's syndrome is a rare neuropsychiatric condition in which the patient denies existence of one's own body to the extent of delusions of immortality. One of the consequences of Cotard's syndrome is self-starvation because of negation of existence of self. Although Cotard's syndrome has been reported to be associated with various organic conditions and other forms of psychopathology, it is less often reported to be seen in patients with catatonia. In this report we present two cases of Cotard's syndrome, both of whom had associated self-starvation and nutritional deficiencies and one of whom had associated catatonia.

  7. Cotard's syndrome: Two case reports and a brief review of literature

    PubMed Central

    Grover, Sandeep; Aneja, Jitender; Mahajan, Sonali; Varma, Sannidhya

    2014-01-01

    Cotard's syndrome is a rare neuropsychiatric condition in which the patient denies existence of one's own body to the extent of delusions of immortality. One of the consequences of Cotard's syndrome is self-starvation because of negation of existence of self. Although Cotard's syndrome has been reported to be associated with various organic conditions and other forms of psychopathology, it is less often reported to be seen in patients with catatonia. In this report we present two cases of Cotard's syndrome, both of whom had associated self-starvation and nutritional deficiencies and one of whom had associated catatonia. PMID:25540544

  8. A Case of Peeling Skin Syndrome.

    PubMed

    Singhal, Anil K; Yadav, Devendra K; Soni, Bajrang; Arya, Savita

    2017-01-01

    Peeling skin syndrome is a very rare autosomal recessive disease characterized by widespread painless peeling of the skin in superficial sheets. Etiology is still unknown with an autosomal recessive inheritance. Less than 100 cases have been reported in the medical literature. We present a 32-year-old man having asymptomatic peeling of skin since birth. Sheets of skin were peeling from his neck, trunk, and extremities, following friction or rubbing especially if pre-soaked in water but sparing palm and soles. Histologically, there was epidermal separation at the level of stratum corneum, just above the stratum granulosum. This case is being presented due to its rarity.

  9. A Case of Peeling Skin Syndrome

    PubMed Central

    Singhal, Anil K.; Yadav, Devendra K.; Soni, Bajrang; Arya, Savita

    2017-01-01

    Peeling skin syndrome is a very rare autosomal recessive disease characterized by widespread painless peeling of the skin in superficial sheets. Etiology is still unknown with an autosomal recessive inheritance. Less than 100 cases have been reported in the medical literature. We present a 32-year-old man having asymptomatic peeling of skin since birth. Sheets of skin were peeling from his neck, trunk, and extremities, following friction or rubbing especially if pre-soaked in water but sparing palm and soles. Histologically, there was epidermal separation at the level of stratum corneum, just above the stratum granulosum. This case is being presented due to its rarity. PMID:28584761

  10. Cronkhite-Canada Syndrome (CCS)-A Rare Case Report.

    PubMed

    Chakrabarti, Subrata

    2015-03-01

    Cronkhite-Canada syndrome (CCS) is an extremely rare non-inherited condition characterized by gastrointestinal hamartomatous polyposis, alopecia, onychodystrophy, hyperpigmentation, weight loss and diarrhoea. The aetiology is probably autoimmune and diagnosis is based on history, physical examination, endoscopic findings of gastrointestinal polyposis, and histology. The disease is very rare; approximately 450 cases of CCS have been reported worldwide. The author reports a case of CCS in an elderly Indian male.

  11. A particular case of deafness-oligodontia syndrome.

    PubMed

    Marlin, S; Denoyelle, F; Busquet, D; Garabedian, N; Petit, C

    1998-06-01

    Two previous case reports described two sibs affected with both sensorineural hearing loss and oligodontia. Here, we report a similar syndrome in a male patient with an, as yet, undescribed vestibular aqueduct enlargement on tomodensitometry. The analysis of the parent's audiograms is consistent with the suggested autosomal recessive mode of inheritance of this disorder.

  12. Naegeli–Franceschetti–Jadassohn syndrome: A rare case

    PubMed Central

    Shah, Bela J.; Jagati, Ashish K.; Gupta, Neha P.; Dhamale, Suyog S.

    2015-01-01

    Naegeli–Franceschetti–Jadassohn Syndrome (NFJS) is a rare, autosomal dominant inherited form of ectodermal dysplasia, caused by mutation in the KRT14 gene. We report here a case of NFJS in a 27-year-old male who presented with reticulate hyperpigmentation over skin, dental changes, absence of dermatoglyphics, hypohidrosis, and hair changes. PMID:26753140

  13. Anticholinergic Toxic Syndrome Caused by Atropa Belladonna Fruit (Deadly Nightshade): A Case Report

    PubMed Central

    Demirhan, Abdullah; Tekelioğlu, Ümit Yaşar; Yıldız, İsa; Korkmaz, Tanzer; Bilgi, Murat; Akkaya, Akcan; Koçoğlu, Hasan

    2013-01-01

    Atropa Belladonna poisoning may lead to anticholinergic syndrome. Ingestion of high amounts of the plant may cause lethargy, coma, and even a serious clinical picture leading to death. In this case report, we aimed to present a case with anticholinergic syndrome that developed after ingestion of the fruit called “Deadly Nightshade” in our country. PMID:27366377

  14. Analysis on shock wave speed of water hammer of lifting pipes for deep-sea mining

    NASA Astrophysics Data System (ADS)

    Zhou, Zhi-jin; Yang, Ning; Wang, Zhao

    2013-04-01

    Water hammer occurs whenever the fluid velocity in vertical lifting pipe systems for deep-sea mining suddenly changes. In this work, the shock wave was proven to play an important role in changing pressures and periods, and mathematical and numerical modeling technology was presented for simulated transient pressure in the abnormal pump operation. As volume concentrations were taken into account of shock wave speed, the experiment results about the pressure-time history, discharge-time history and period for the lifting pipe system showed that: as its concentrations rose up, the maximum transient pressure went down, so did its discharges; when its volume concentrations increased gradually, the period numbers of pressure decay were getting less and less, and the corresponding shock wave speed decreased. These results have highly coincided with simulation results. The conclusions are important to design lifting transporting system to prevent water hammer in order to avoid potentially devastating consequences, such as damage to components and equipment and risks to personnel.

  15. Depression and Dementia in Aging Adults with Down Syndrome: A Case Study Approach.

    ERIC Educational Resources Information Center

    Sung, Hyunsook; And Others

    1997-01-01

    A case study of three adults (ages 46-47) with Down syndrome investigated the patterns of symptoms associated with depression and dementia. Characteristics that distinguish between dementia and depression in adults with Down syndrome are described. Periodic comprehensive assessment of adults with Down syndrome to detect functioning changes is…

  16. [Multiorgan autoimmune syndrome: case report].

    PubMed

    Ghiringhelli, Paolo; Chelazzi, Paolo; Chelazzi, Giovanni; Bellintani, Claudio; Rania, Simone

    2003-01-01

    The present case report refers to a multiorgan autoimmune disease manifesting following thymectomy performed for a benign thymoma. This disease is characterized by hypothyroidism, severe myasthenia, polymyositis and alopecia which are organ-specific diseases probably with a different time of onset but which are all an expression of the same immunopathologic process occurring in individuals who have a genetic predisposition. Characteristic of the present case is not only the association of the different immunopathologic clinical pictures but also the rather difficult differential diagnosis between a hypothyroidism-related myopathy and polymyositis. It was possible to formulate the diagnosis by integrating the results of clinical and laboratory evaluation with the therapeutic outcome. The onset of the syndrome was attributed to the withdrawal, following surgery, of the inhibitory effects of the thymoma on some clones of autoreactive lymphocytes.

  17. Acute organic brain syndrome: a review of 100 cases.

    PubMed

    Purdie, F R; Honigman, B; Rosen, P

    1981-09-01

    A retrospective review of 100 admissions to Denver General Hospital with a diagnosis of acute organic brain syndrome was conducted. A total of 44% of the patients were found to have a chronic organic brain syndrome with a superimposed acute insult which caused decompensation. The other 56% of patients developed acute organic brain syndromes de novo for a variety of reasons. The most common etiologic factors producing decompensation of the chronic OBS were infections (in 23%) and environmental changes (in 17%). The most common etiologic factor causing AOBS de novo was drug-related. In most cases, a toxicologic screen, lumbar puncture, and CT scan of the brain should be a part of the investigation of any patient with AOBS.

  18. Goodpasture's Syndrome and Silica: A Case Report and Literature Review

    PubMed Central

    Dahlgren, James; Wardenburg, Marla; Peckham, Trevor

    2010-01-01

    We report a case of Goodpasture's syndrome following chronic low level and an acute, high level of exposure to crystalline silica. A 38-year-old male tilesetter was admitted to the emergency room with dyspnea and respiratory failure. He reported that his symptoms had developed over the previous week after inhaling a large amount of dust while dry-sanding and sweeping a silica-based product used to fill cracks in a cement floor. Over the following days, his pulmonary function declined and he developed acute renal failure. Tests of antiglomerular basement membrane antibody were positive and renal biopsy revealed global glomerulonephritis. He was diagnosed with Goodpasture's syndrome and treated with steroids, plasmapheresis, and hemodialysis. This man had a history of childhood asthma and a remote, one pack-year history of cigarette use. He used the flooring product for seven years prior to the inciting event, however, previous jobs had utilized significantly smaller amounts. Goodpasture's syndrome and other autoimmune diseases have been reported in association with silica exposure. The acute onset following high level silica exposure in this previously healthy man, suggest that clinicians should investigate silica exposure as a causal factor in cases of Goodpasture's syndrome. PMID:20886021

  19. Clear otorrhea: a case of Munchausen syndrome in a pediatric patient

    PubMed Central

    Özmen, Ömer Afşin; Yılmaz, Taner

    2007-01-01

    This paper reports a case of Munchausen syndrome in a pediatric patient. An 11-year-old girl presented with the complaint of clear fluid otorrhea. She underwent numerous investigations with deception of the physicians. The literature with respect to Munchausen syndrome in the pediatric patient is reviewed. Diagnosis of Munchausen syndrome is difficult especially during the initial assessment, although suspicion might be aroused by inconsistencies in the patient’s history and discrepancies between signs and symptoms. PMID:18030485

  20. [Cryptorchidism with didymo-epididymal dissociation and Robinow's syndrome: 2 case reports].

    PubMed

    Fabbro, M A; D'Agostino, S; Costa, L; Musi, L; Cappellari, F

    1997-01-01

    Two brothers of normal not consanguineous parents, with bilateral intrabdominal cryptorchidism, were admitted to our Institution. Both children had short stature, limb and hand malformations and craniofacial patterns of Robinow syndrome. During the orchidopexy, bilateral epididymal and vasal abnormalities were found in both of them. This anomaly associated with Robinow syndrome has never been reported before. These two cases provides the Authors with the opportunity of reviewing clinical features, genetics and radiological patterns of this rare syndrome.

  1. A rare case of infectious mononucleosis complicated by guillain-barre syndrome.

    PubMed

    Kennedy, Margaret; Apostolova, Mariya

    2013-06-25

    Infectious mononucleosis is a clinical syndrome characterized by fever, lymphadenopathy and pharyngitis. Neurologic complications of infectious mononucleosis, such as the development of Guillain-Barre syndrome, have been rarely reported and usually present late in the course of the disease. We describe a case of a 29 year old male with no significant past medical history who was diagnosed with Guillain-Barre syndrome following an infection with Epstein-Barr virus associated infectious mononucleosis. Supportive treatment resulted in full recovery.

  2. Genome sequence of the thermophile Bacillus coagulans Hammer, the type strain of the species.

    PubMed

    Su, Fei; Tao, Fei; Tang, Hongzhi; Xu, Ping

    2012-11-01

    Here we announce a 3.0-Mb assembly of the Bacillus coagulans Hammer strain, which is the type strain of the species within the genus Bacillus. Genomic analyses based on the sequence may provide insights into the phylogeny of the species and help to elucidate characteristics of the poorly studied strains of Bacillus coagulans.

  3. Pressure signature and evaluation of hammer pulses during underwater implosion in confining environments.

    PubMed

    Gupta, Sachin; Matos, Helio; Shukla, Arun; LeBlanc, James M

    2016-08-01

    The fluid structure interaction phenomenon occurring in confined implosions is investigated using high-speed three-dimensional digital image correlation (DIC) experiments. Aluminum tubular specimens are placed inside a confining cylindrical structure that is partially open to a pressurized environment. These specimens are hydrostatically loaded until they naturally implode. The implosion event is viewed, and recorded, through an acrylic window on the confining structure. The velocities captured through DIC are synchronized with the pressure histories to understand the effects of confining environment on the implosion process. Experiments show that collapse of the implodable volume inside the confining tube leads to strong oscillating water hammer waves. The study also reveals that the increasing collapse pressure leads to faster implosions. Both peak and average structural velocities increase linearly with increasing collapse pressure. The effects of the confining environment are better seen in relatively lower collapse pressure implosion experiments in which a long deceleration phase is observed following the peak velocity until wall contact initiates. Additionally, the behavior of the confining environment can be viewed and understood through classical water hammer theory. A one-degree-of-freedom theoretical model was created to predict the impulse pressure history for the particular problem studied.

  4. Child health in the workplace: the Supreme Court in Hammer v. Dagenhart (1918).

    PubMed

    Berger, L R; Johansson, S R

    1980-01-01

    Exploitation of children in the labor force at the beginning of this century gave rise to a national campaign leading to congressional passage of the Keating-Owen Act in 1916. The act prohibited from interstate commerce goods produced in factories or mines that employed children who either were under fourteen years of age or who were under sixteen years of age and worked more than eight hours a day. Despite its popular support, the Act was declared unconstitutional by the Supreme Court in Hammer v. Dagenhart (1918). The Court's decision involved several major issues: interpretation of the Fifth and Fourteenth Amendments to the Constitution, freedom of contract, police power of the states, and the interstate commerce clause. Review of previous Court decisions suggests that the justices were on less than solid legal ground in reaching their decision. Examination of the historical context of the decision, however, suggests other factors that may have played a more important role than judicial precedents. The debate prompted by Hammer v. Dagenhart has much relevance to such current issues as young agricultural workers, sex discrimination in industry, and the powers of the federal government vis-a-vis states and individual citizens.

  5. Fluid-structure interaction with pipe-wall viscoelasticity during water hammer

    NASA Astrophysics Data System (ADS)

    Keramat, A.; Tijsseling, A. S.; Hou, Q.; Ahmadi, A.

    2012-01-01

    Fluid-structure interaction (FSI) due to water hammer in a pipeline which has viscoelastic wall behaviour is studied. Appropriate governing equations are derived and numerically solved. In the numerical implementation of the hydraulic and structural equations, viscoelasticity is incorporated using the Kelvin-Voigt mechanical model. The equations are solved by two different approaches, namely the Method of Characteristics-Finite Element Method (MOC-FEM) and full MOC. In both approaches two important effects of FSI in fluid-filled pipes, namely Poisson and junction coupling, are taken into account. The study proposes a more comprehensive model for studying fluid transients in pipelines as compared to previous works, which take into account either FSI or viscoelasticity. To verify the proposed mathematical model and its numerical solutions, the following problems are investigated: axial vibration of a viscoelastic bar subjected to a step uniaxial loading, FSI in an elastic pipe, and hydraulic transients in a pressurised polyethylene pipe without FSI. The results of each case are checked with available exact and experimental results. Then, to study the simultaneous effects of FSI and viscoelasticity, which is the new element of the present research, one problem is solved by the two different numerical approaches. Both numerical methods give the same results, thus confirming the correctness of the solutions.

  6. Red ear syndrome precipitated by a dietary trigger: a case report

    PubMed Central

    2014-01-01

    Introduction Red ear syndrome is a rare condition characterized by episodic attacks of erythema of the ear accompanied by burning ear pain. Symptoms are brought on by touch, exertion, heat or cold, stress, neck movements and washing or brushing of hair. Diagnosis and treatment of this condition are challenging. The case we report here involves a woman whose symptoms were brought on by a dietary trigger: orange juice as well as stress, causing significant physical and psychological morbidity. Avoidance of triggers resulted in symptomatic improvement. Case presentation A 22-year-old Caucasian woman who was a student presented twice to our department with evolving symptoms, the first time with hyperacusis (abnormal sound sensitivity arising from within the auditory system to sounds of moderate volume), intermittent right tinnitus and subjective hearing difficulties. She presented five years later with highly distressing episodes of erythematous ears, which were associated with burning pain around the ear and temporal areas, and intolerance to noise. After keeping a symptom diary, she identified orange juice and stress as triggers of her symptoms. No local head and neck pathology was present. Investigations and imaging were negative. Avoidance of triggers led to great symptomatic improvement. To the best of our knowledge, dietary triggers have not previously been reported as a trigger for this syndrome. This case shows a direct temporal link to a dietary trigger and supports a primary pathogenesis. Recognition and management of primary headache disorder and simple dietary and lifestyle changes brought about symptomatic relief. Conclusion Red ear syndrome is a little-known clinical syndrome of unknown etiology and management. To the best of our knowledge, our present case report is the first to describe primary red ear syndrome triggered by orange juice. Clinical benefit derived from avoidance of this trigger, which is already known to precipitate migraines, gives some

  7. Amniotic Band Syndrome: A Review of 2 Cases.

    PubMed

    Madan, Siddharth; Chaudhuri, Zia

    2018-04-03

    Amniotic band syndrome is a rare congenital disorder caused by entrapment of fetal parts (usually a limb or digits) in fibrous amniotic bands while in utero that presents with complex multisystem anomalies. The authors report 2 children with amniotic band syndrome who presented to the ophthalmic unit of the authors' pediatric hospital. One of them presented with telecanthus, syndactyly, amputated toes, and unilateral epiphora diagnosed as congenital nasolacrimal duct obstruction. She was managed conservatively with lacrimal sac massage and provided with refractive correction while she simultaneously underwent multiple surgeries for correction of clubfoot and craniosynostosis. The second patient presented with cleft lip, cleft palate, multiple constriction bands in upper limbs and fingers with unilateral microphthalmos, microcornea, typical iris coloboma, and retinochoroidal coloboma, very similar to a case reported in literature. These 2 cases provide an overview of the clinical spectrum of ophthalmic manifestations along with their staged optimum rehabilitation.

  8. [Scimitar syndrome: a case series].

    PubMed

    Jaramillo González, Carlos; Karam Bechara, José; Sáenz Gómez, Jessica; Siegert Olivares, Augusto; Jamaica Balderas, Lourdes

    Scimitar syndrome is a rare and complex congenital anomaly of the lung with multiple variables and is named for its resemblance to the classical radiological crooked sword. Its defining feature is the anomalous pulmonary drainage. It is associated with various cardiothoracic malformations and a wide spectrum of clinical manifestations. Nine patients diagnosed with scimitar syndrome found in the database of Hospital Infantil de México between 2009 and 2013 were reviewed. Demographic records, clinical status and hemodynamic parameters reported were collected. This case series called attention to certain differences between our group of patients and those reported in the international literature. Patients were predominantly female and were diagnosed between 1 and 20 months of life. All were asymptomatic at the time of the study. Half of the patients had a history of respiratory disease and all patients had with pulmonary hypertension. Surgical management was required in on-third of the patient group. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  9. Kindler syndrome: the case of two Iranian sisters.

    PubMed

    Kargar, Saeed; Shiryazdi, Seyed M; Neamatzadeh, Hossein; Ramazani, Vahid

    2018-02-01

    Kindler syndrome is a rare autosomal recessive condition, characterized by multiple skin and mucosal abnormalities. Among the latter, esophageal involvement is an infrequent manifestation which may be completely asymptomatic or complicated by dysphagia. We report the case of two sisters presenting with cutaneous features and severe dysphagia. Endoscopic examination showed that the patients were affected by a rare condition named "esophageal web". Both patients showed significant improvement after balloon dilation. Clinicians should be aware of the potential complications of this disease, and the approach by balloon dilation should be considered as primary therapy in Kindler syndrome patients with esophageal web.

  10. Gitelman's Syndrome Presenting with Hypocalcaemia - A Case Report.

    PubMed

    Cader, F A; Kabir, A; Mayedah, R; Masud, M S; Quadir, F; Hossen, M N

    2015-04-01

    Gitelman's syndrome is an autosomal recessive renal tubular disorder characterized by severe hypomagnesaemia, hypokalaemia, metabolic alkalosis and hypocalcaemia. It is caused by defective NaCl transport in the Distal Convoluted Tubule and presents in adolescence or adulthood, with a distinctly more benign course than Bartter's Syndrome. The dominant clinical features are muscle weakness, fatigue, carpopedal spasm, cramps and tetany. We report the case of a 26 year old male who presented with flaccid quadriparesis and carpopedal spasms, hypokalaemia, hypomagnesaemia, hypocalcaemia and severe urinary magnesium wasting. He was treated with potassium and magnesium supplementation and regained full function of all limbs.

  11. [RS3PE syndrome: report of 11 cases].

    PubMed

    Bruscas Izu, C; Medrano San Ildefonso, M; Simon, L

    2000-09-01

    The RS3P syndrome or remitting seronegative symmetrical synovitis with pitting oedema, was described in 1985 by McCarty. The description refers to a rheumatologic set of symptoms with an acute commence, with no erosive lesions, with seronegativity, affecting more frequently to elderly males and showing an excellent prognosis. These characteristics make it possible to difference from the rheumatoid arthritis and from the rheumatic polymyalgia. We present eleven cases which confirm the good prognosis already described, but we suggest the possibility of this syndrome could be a manifestation or the beginning of other possible diseases.

  12. [Clinical analysis of 6 cases of Bartter syndrome].

    PubMed

    Yin, Fang-mei; Zheng, Fang-qiu; Zhang, Xin; Wu, Mei-jun; Wei, Hong-yan; Ma, Zhong-shu; Lu, Biao; Qiu, Ming-cai

    2011-03-01

    To summarize the clinical characteristics of Bartter syndrome and investigate its pathogenesis. The clinical data of 6 cases of Bartter syndrome at our hospital from November 2006 to May 2010 were analyzed retrospectively. The onset age of Bartter syndrome was 13-35 years old. The main symptoms included weakness (6/6), paralysis (1/6), numbness (5/6) and tetany (4/6). All patients had normal blood pressure. The biochemical tests showed persistent hypokalemia, metabolic alkalosis (6/6) and hyperreninemia. The pathological examination of deltoid muscle biopsy showed the swelling, degeneration and necrosis of myocytes and the deposition of immunocomplex in myolemma. And the pathological examination of renal biopsy showed the hyperplasia of juxtaglomerular apparatus (5/6) and the deposition of immunocomplex. All symptoms were relieved after a therapy of potassium supplementation or a combination of indomethacin, spironolactone and immunosuppressant. When such clinical features as weakness, paralysis, tetany, hypokalemic alkalosis and normotension are encountered, Bartter syndrome should be suspected. Serum electrolytes, blood gas analysis and activation of the renin-angiotensin-aldosterone system should be examined for a definite diagnosis. The treatment of choice includes potassium and magnesium supplementation or in combination with prostaglandin synthetase inhibitor, aldosterone antagonist and immunosuppressant. Immunologic mechanism may participate in the course of Bartter syndrome.

  13. [Kindler syndrome: three cases reports in three siblings].

    PubMed

    Ezzine Sebaï, N; Trojjet, S; Khaled, A; Zekri, S; Fazaa, B; Jaafoura, M-H; Kamoun, M-R

    2007-10-01

    Kindler syndrome is a rare type of genetic skin condition belonging to the class of bullous poikilodermia. We report three new cases of this rare syndrome. This condition was seen in two brothers aged 4 and 14 years and in their sister aged 6 years, born of a first-degree consanguineous marriage in a family with Kindler syndrome of varying degrees of severity. The three patients presented spontaneously regressive bullous eruptions, poikilodermia of gradual onset, major cutaneous atrophy on the back of the hands and the feet, pseudo-syndactyly and photosensitivity. The older brother presented a severe form complicated by chronic terminal renal failure with hydronephrosis secondary to urethral stenosis and hypertension as well as oesophageal stenosis requiring dilatation sessions. Electron microscopy examination of poikilodermic skin showed normal anchoring filaments and proliferation of the basal layer. Electron microscopy examination of rubbed poikilodermic skin from the other two siblings showed cleavage at both the superficial and deep intra-epidermal levels. Diagnosis of Kindler syndrome is based upon clinical evidence. Electron microscopic examination is used in particular to rule out congenital bullous epidermolysis. Detachment of layers at two or three different levels in relation to the dermal-epidermal junction described in the literature forms a specific but inconsistent feature of Kindler syndrome.

  14. [Mirizzi's syndrome. Evaluation of 3 cases].

    PubMed

    Garavello, A; Manfroni, S; Bellanova, G; Antonellis, D

    2004-01-01

    Evaluation of three cases of Mirizzi's syndrome (MS), a rare condition of non neoplastic biliary tree obstruction. We reviewed three cases of MS, operated from July 1998 to December 2000 in our institution. All patients were preoperatively evaluated by clinical examination, Ultrasound (US) and Endoscopic retrograde colangiopancreatography (CPRE) for jaundice. Computed Tomography (TC) was also performed in two. Abdominal pain was the main symptom in two patients, jaundice in one (17 mg/dl); Courvoisier-Terrier sign, suggestive for a biliopancreatic neoplasm, was present in two patients. US was sensitive for gallbladder stones and biliary tree dilatation but not specific for MS; TC only excluded a malignancy in the biliopancreatic area but wasn't useful for diagnosis. CPRE visualized a gallbladder stone obstructing the biliary tree in two cases, but failed to show the fistula between gallbladder and hepatic duct in one. Operations were performed with an "open" approach; in two patients colecystectomy was sufficient to relieve the obstruction, in one patient the biliary fistula was closed with a gallbladder tissue flap over a T tube. Mirizzi's syndrome is a rare condition, but surgeons must be aware of it, particularly in the laparoscopic era were dissection of the Calot triangle may lead to a damage of the hepatic duct. Suspect of MS is mandatory in all cases of jaundice with non neoplastic biliary obstruction. Preoperative diagnosis of MS is not easy; US is sensitive for gallbladder stone and biliary tree dilatation, but not specific for choledochal stone compression and biliobiliary fistula. TC is useful for exclusion of pancreatic or liver neoplasms but is non specific for MS. CPRE represents the "gold" standard for MS, showing the hepatic duct compression caused by the stone impacted in gallbladder neck. CPRE is not only diagnostic but also operative; sphyncterotomy and stones extraction give a temporary relief of hyerbilirubinemia waiting for operation. When

  15. A case of Pitt-Hopkins syndrome with absence of hyperventilation.

    PubMed

    Inati, Adlette; Abbas, Hussein A; Korjian, Serge; Daaboul, Yazan; Harajeily, Mohamad; Saab, Raya

    2013-12-01

    Pitt-Hopkins syndrome is characterized by mental retardation, hyperventilation, and dysmorphic features due to TCF4 mutations. We report a case of Pitt-Hopkins syndrome in a 2½-year-old boy presenting with psychomotor retardation, recurrent respiratory tract infections, and dysmorphic features with absence of hyperventilation or other breathing abnormalities. Comparative genomic hybridization and quantitative real-time polymerase chain reaction were used to confirm TCF4 haploinsufficiency. Pitt-Hopkins syndrome is a rare debilitating disease that should be in the differential diagnosis of other neurodevelopmental disorders characterized by mental retardation and hypotonicity despite the absence of hyperapnea and seizures. Quantitative real-time polymerase chain reaction is another method to identify TCF4 and to confirm Pitt-Hopkins syndrome diagnosis.

  16. A challenging case of an ectopic cushing syndrome.

    PubMed

    Menezes Nunes, Joana; Pinho, Elika; Camões, Isabel; Maciel, João; Cabral Bastos, Pedro; Souto de Moura, Conceição; Bettencourt, Paulo

    2014-01-01

    Bronchopulmonary carcinoids are rare pulmonary neoplasms although they account for most cases of ectopic ACTH syndromes. When feasible, the mainstay treatment is surgical resection of the tumor. We report the case of a 52-year-old woman with signs and symptoms suggestive of hypercortisolism for 12 months, admitted to our department because of community acquired pneumonia. Blood hormone analysis showed increased levels of ACTH and urinary free cortisol and nonsuppressibility to high- and low-dose dexamethasone tests. Pituitary MRI showed no lesion and no central-to-peripheral ACTH gradient was present in bilateral inferior petrosal sinus sampling. CRH stimulation test suggested an ectopic ACTH source. Thoracic CT scan revealed a nodular region measuring 12 mm located in the inferior lingular lobule of the left superior lung with negative uptake by (18)-FDG-PET scan and negative SRS. The patient was successfully treated with an atypical lung resection and histology revealed an atypical bronchial carcinoid tumor with positive ACTH immunoreactivity. This was an interesting case because the patient was admitted due to pneumonia that may have been associated with her untreated and chronic hypercortisolism and a challenging case of ectopic ACTH syndrome due to conflicting results on the diagnostic exams.

  17. Osmotic demyelination syndrome associated with hypophosphataemia: 2 cases and a review of literature.

    PubMed

    Turnbull, Jessica; Lumsden, Daniel; Siddiqui, Ata; Lin, Jean-Pierre; Lim, Ming

    2013-04-01

    Central and extrapontine myelinolysis are collectively known as osmotic demyelination syndrome. This encephalopathic illness has been well documented in the adult literature, occurring most commonly in the context of chronic alcoholism, correction of hyponatraemia and liver transplantation. Aetiology and outcome in the paediatric population are less well understood. Two cases of osmotic demyelination syndrome occurring in children with transient severe hypophosphataemia during the course of their illness are presented. Both had very different neurological outcomes, but the changes of central and extrapontine myelinolysis were apparent on neuroimaging. Sixty-one cases in the paediatric literature were then reviewed. We summarize aetiology and outcome in paediatric cases of osmotic demyelination syndrome and postulate a role for hypophosphataemia as a contributing factor in the development of these sometimes devastating conditions. Hypophosphataemia may contribute to the risk of developing osmotic demyelination syndrome in at-risk paediatric patients and further study of this association should be undertaken. ©2012 The Author(s)/Acta Paediatrica ©2013 Foundation Acta Paediatrica.

  18. A Case of HELLP Syndrome in a Patient with Immune Thrombocytopenic Purpura

    PubMed Central

    Ben, Sebastián; Rodríguez, Fabián; Severo, Carlos; Debat, Natalia

    2010-01-01

    We will describe the clinical case of a pregnant patient with chronic Immune Thrombocytopenic Purpura who develops preeclampsia syndrome with HELLP syndrome. These concomitant and independent conditions become complex, resulting in thrombocytopenia which creates diagnostic, prognostic and therapeutic inconveniences. PMID:20871821

  19. Chronic calcific constrictive pericarditis complicating Churg-Strauss syndrome: first reported case.

    PubMed

    Aboukhoudir, Falah; Pansieri, Michel; Rekik, Sofiene

    2014-10-01

    Churg-Strauss syndrome is a necrotizing systemic vasculitis characterized by extravascular granulomas and eosinophilic infiltrates of small vessels. Although cardiac complications are considered to be relatively common, no case of constrictive calcified pericarditis has ever been previously described in this setting. In this report, we present the case of a 46-year-old man with Churg-Strauss syndrome, in whom we were able to document the development of symptomatic calcific constrictive pericarditis during a 10-year period despite long-term corticosteroid therapy. Georg Thieme Verlag KG Stuttgart · New York.

  20. Genome Sequence of the Thermophile Bacillus coagulans Hammer, the Type Strain of the Species

    PubMed Central

    Su, Fei; Tao, Fei; Tang, Hongzhi

    2012-01-01

    Here we announce a 3.0-Mb assembly of the Bacillus coagulans Hammer strain, which is the type strain of the species within the genus Bacillus. Genomic analyses based on the sequence may provide insights into the phylogeny of the species and help to elucidate characteristics of the poorly studied strains of Bacillus coagulans. PMID:23105047

  1. A Rare Case of Infectious Mononucleosis Complicated by Guillain-Barre Syndrome

    PubMed Central

    Kennedy, Margaret; Apostolova, Mariya

    2013-01-01

    Infectious mononucleosis is a clinical syndrome characterized by fever, lymphadenopathy and pharyngitis. Neurologic complications of infectious mononucleosis, such as the development of Guillain-Barre syndrome, have been rarely reported and usually present late in the course of the disease. We describe a case of a 29 year old male with no significant past medical history who was diagnosed with Guillain-Barre syndrome following an infection with Epstein-Barr virus associated infectious mononucleosis. Supportive treatment resulted in full recovery. PMID:23888210

  2. Anesthetic considerations for a pediatric patient with Wolf-Hirschhorn syndrome: a case report.

    PubMed

    Tsukamoto, Masanori; Yamanaka, Hitoshi; Yokoyama, Takeshi

    2017-09-01

    Wolf-Hirschhorn syndrome is a rare hereditary disease that results from a 4p chromosome deletion. Patients with this syndrome are characterized by craniofacial dysgenesis, seizures, growth delay, intellectual disability, and congenital heart disease. Although several cases have been reported, very little information is available on anesthetic management for patients with Wolf-Hirschhorn syndrome. We encountered a case requiring anesthetic management for a 2-year-old girl with Wolf-Hirschhorn syndrome. The selection of an appropriately sized tracheal tube and maintaining intraoperatively stable hemodynamics might be critical problems for anesthetic management. In patients with short stature, the tracheal tube size may differ from what may be predicted based on age. The appropriate size ( internal diameter ) of tracheal tubes for children has been investigated. Congenital heart disease is frequently associated with Wolf-Hirschhorn syndrome. Depending on the degree and type of heart disease, careful monitoring of hemodynamics is important.

  3. Type IV Ehlers-Danlos Syndrome: A Surgical Emergency? A Case of Massive Retroperitoneal Hemorrhage

    PubMed Central

    Chun, Stephen G; Pedro, Patrick; Yu, Mihae; Takanishi, Danny M

    2011-01-01

    Retroperitoneal hemorrhagic bleeding is a known manifestation of Type-IV Ehlers-Danlos Syndrome that is caused by loss-of-function mutations of the pro-alpha-1 chains of type III pro-collagen (COL3A1) resulting in vascular fragility. A number of previous reports describe futile surgical intervention for retroperitoneal bleeding in Type-IV Ehlers-Danlos Syndrome with high post-operative mortality, although the rarity of retroperitoneal bleeding associated with Type-IV Ehlers-Danlos Syndrome precludes an evidence-based approach to clinical management. We report a 23-year-old male with history of Type-IV Ehlers-Danlos Syndrome who presented with severe abdominal pain and tachycardia following an episode of vomiting. Further work-up of his abdominal pain revealed massive retroperitoneal bleeding by CT-scan of the abdomen. Given numerous cases of catastrophic injury caused by surgical intervention in Type-IV Ehlers-Danlos Syndrome, the patient was treated non-operatively, and the patient made a full recovery. This case suggests that even in cases of large retroperitoneal hemorrhages associated with Ehlers-Danlos Syndrome, it may not truly represent a surgical emergency. PMID:21966332

  4. Acute Exertional Compartment Syndrome with Rhabdomyolysis: Case Report and Review of Literature

    PubMed Central

    Gaunder, Christopher; Schumer, Ross

    2018-01-01

    Patient: Male, 17 Final Diagnosis: Acute exertional compartment syndrome Symptoms: Foot drop • leg pain • paresthesia Medication: — Clinical Procedure: Fasciotomy Specialty: Orthopedics and Traumatology Objective: Rare disease Background: Acute exertional compartment syndrome (AECS) is a rare cause of leg pain often associated with a delay in diagnosis and potentially leading to irreversible muscle and nerve damage. Case Report: We present the case of a previously healthy, high-level athlete who presented with the acute onset of unilateral anterior leg pain and foot drop the day after a strenuous workout. He was diagnosed with compartment syndrome and rhabdomyolysis. His management included emergent fluid resuscitation, fasciotomies, debridement of necrotic muscle from his anterior compartment, and delayed primary closure. After six months of intensive outpatient physical therapy, including the use of blood flow restriction treatments, the patient returned to sports and received a NCAA Division I Football scholarship. Conclusions: We describe the details of this patient’s case and review the literature related to acute exertional compartment syndrome. The occurrence of acute compartment syndrome in the absence of trauma or fracture, though rare, can have devastating consequences following delays in treatment. AECS requires prompt diagnosis and surgical intervention to prevent these consequences. Diagnosis of atraumatic cases can be difficult, which is why awareness is equally as important as history and physical examination. While diagnosis is primarily clinical, it can be supported with direct intra-compartmental pressure measurements and maintaining a high index of suspicion in acute presentations of exertional limb pain. PMID:29415981

  5. Anorexia nervosa and Wernicke-Korsakoff syndrome: a case report

    PubMed Central

    2010-01-01

    Introduction Wernicke's encephalopathy is an acute, potentially fatal, neuropsychiatric syndrome resulting from thiamine deficiency. The disorder is still greatly under-diagnosed, and failure to promptly identify and adequately treat the condition can lead to death or to the chronic form of the encephalopathy - Korsakoff's syndrome. Wernicke's encephalopathy has traditionally been associated with alcoholism but, in recent years, there has been an increase in the number of clinical settings in which the disorder is observed. Case presentation We report the case of a 45-year-old Caucasian woman who arrived at the emergency room presenting signs of marked malnutrition and mental confusion, ataxic gait and ophthalmoplegia. Main laboratory test findings included low serum magnesium and megaloblastic anemia. Brain magnetic resonance imaging revealed increased T2 signal in the supratentorial paraventricular region, the medial regions of the thalamus and the central and periaqueductal midbrain. The diagnosis of Wernicke's encephalopathy was made at once and immediate reposition of thiamine and magnesium was started. The patient had a long history of recurrent thoughts of being overweight, severe self-imposed diet restrictions and self-induced vomiting. She had also been drinking gin on a daily basis for the last eight years. One day after admittance the acute global confusional state resolved, but she presented severe memory deficits and confabulation. After six months of outpatient follow-up, memory deficits remained unaltered. Conclusion In this case, self-imposed long-lasting nutritional deprivation is thought to be the main cause of thiamine deficiency and subsequent encephalopathy, but adjunct factors, such as magnesium depletion and chronic alcohol misuse, might have played an important role, especially in the development of Korsakoff's syndrome. The co-morbidity between eating disorders and substance abuse disorders has emerged as a significant health issue for

  6. Psychosis in a Case of Dandy-Walker Syndrome: A Case Report.

    PubMed

    Dawra, Ripu Daman; Karia, Sagar; Shah, Nilesh; Desousa, Avinash

    2017-05-01

    Dandy Walker Syndrome (DWS) is a congenital malformation with brain abnormalities, intellectual disabilities, epilepsy and visible structural changes in particular brain structures. We present here a case of psychosis in an 18-year-old male with DWS, epilepsy and intellectual disability. The purpose of this paper is to discuss the clinically relevant issues, psychopharmacological issues, neuropsychiatric manifestations and consultation liaison issues involved.

  7. A report of two cases of Al-Awadi Raas-Rothschild syndrome (AARRS) supporting that "apparent" Phocomelia differentiates AARRS from Schinzel Phocomelia syndrome (SPS).

    PubMed

    AlQattan, Mohammad M; AlAbdulkareem, Ibrahim; Ballow, Mariam; Al Balwi, Mohammed

    2013-09-15

    Although there is a long list of syndromes with phocomelia, there are only two syndromes in which there is concurrent pelvic dysplasia and phocomelia: Al-Awadi-Raas-Rothschild syndrome (AARRS) and Schinzel phocomelia syndrome (SPS). Currently, there is a diagnostic confusion between the two syndromes and both have the same MIM entry (MIM 276820). We believe that the two syndromes are different entities and we also believe that the limb defect in SPS is a "true" phocomelia while the limb defect in AARRS is an "apparent" phocomelia. "Apparent" phocomelia describes the most severe form of ulnar ray deficiency in which there is absent ulna with radio-humeral synostosis. "Apparent" phocomelia is diagnosed radiologically by three radiological features: the apparently single bone occupying the arm/forearm appears relatively long, the area of radio-humeral synostosis will have thicker cortex with or without slight angulation, and the lower end of the bone resembles the lower end of a radius and not a humerus. In this paper, we present two new cases of AARRS from two different Saudi Arabian tribes: one case with R292C mutation of WNT7A with bilateral "apparent" phocomelia and a second case with a novel c.814G>T mutation of the WNT7A gene (resulting in wnt7a protein truncation at position 272) with unilateral "apparent" phocomelia. We reviewed previously reported cases of AARRS and SPS to further delineate the differences between these two syndromes. We make the argument that these two syndromes are two different entities and hence require two different MIM entries. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. Transient myeloproliferative disorder in neonates without Down syndrome: case report and review.

    PubMed

    Schifferli, Alexandra; Hitzler, Johann; Bartholdi, Deborah; Heinimann, Karl; Hoeller, Sylvia; Diesch, Tamara; Kühne, Thomas

    2015-05-01

    Transient myeloproliferative disorder (TMD) is a clonal proliferation of megakaryoblasts, typically occurring in newborns with Down syndrome. It is believed that TMD occurs in the presence of GATA1 mutation together with trisomy 21. However, a limited number of patients with TMD but without Down syndrome have been reported, all with a blast population with numeric or rarely structural chromosome 21 abnormalities. We present the first case of a newborn boy with a TMD without trisomy 21 and without any of the mentioned molecular or cytogenetic abnormalities. This case report suggests that unknown disease mechanisms may provoke or mimic TMD. This case report is followed by a concise review of the literature discussing the different entities and pathomechanisms of TMD and acute megakaryocytic leukaemia in patients with or without Down syndrome. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Case Study of Childhood Disintegrative Disorder--Heller's Syndrome.

    ERIC Educational Resources Information Center

    Bray, Melissa A.; Kehle, Thomas J.; Theodore, Lea A.; Broudy, Matthew S.

    2002-01-01

    Discusses the case of a 25-year-old male with childhood disintegrative disorder (CDD), or Heller's syndrome, in terms of differential diagnosis, progression of the disorder, and suggestions for home- and school-based interventions. Documents the progressive deterioration of cognitive and social competencies. (Contains 23 references.) (GCP)

  10. Symptomatic Cushing's syndrome and hyperandrogenemia in a steroid cell ovarian neoplasm: a case report.

    PubMed

    Sedhom, Ramy; Hu, Sophia; Ohri, Anupam; Infantino, Dorian; Lubitz, Sara

    2016-10-12

    Malignant steroid cell tumors of the ovary are rare and frequently associated with hormonal abnormalities. There are no guidelines on how to treat rapidly progressive Cushing's syndrome, a medical emergency. A 67-year-old white woman presented to our hospital with rapidly developing signs and symptoms of Cushing's syndrome secondary to a steroid-secreting tumor. Her physical and biochemical manifestations of Cushing's syndrome progressed, and she was not amenable to undergoing conventional chemotherapy secondary to the debilitating effects of high cortisol. Her rapidly progressive Cushing's syndrome ultimately led to her death, despite aggressive medical management with spironolactone, ketoconazole, mitotane, and mifepristone. We report an unusual and rare case of Cushing's syndrome secondary to a malignant steroid cell tumor of the ovary. The case is highlighted to discuss the complications of rapidly progressive Cushing's syndrome, an underreported and often unrecognized endocrine emergency, and the best available evidence for treatment.

  11. Implant rehabilitation for a patient with Hallerman-Streiff syndrome: a case report.

    PubMed

    Abadi, Behruz J; Van Sickels, Joseph E; McConnell, Thomas A; Kluemper, G Thomas

    2009-01-01

    Hallermann-Streiff syndrome is a rare genetic disorder characterized by craniofacial malformations, sparse hair, eye abnormalities, dental defects, degenerative skin changes, and short stature. The syndrome has many implications for dental treatment. Patients typically present with multiple missing and poorly formed teeth. The purpose of this case report is to discuss the overall management of a patient with Hallermann-Streiff syndrome by oral maxillofacial surgery, orthodontic treatment, and prosthodontic reconstruction.

  12. Dynamic Brazilian Test of Rock Under Intermediate Strain Rate: Pendulum Hammer-Driven SHPB Test and Numerical Simulation

    NASA Astrophysics Data System (ADS)

    Zhu, W. C.; Niu, L. L.; Li, S. H.; Xu, Z. H.

    2015-09-01

    The tensile strength of rock subjected to dynamic loading constitutes many engineering applications such as rock drilling and blasting. The dynamic Brazilian test of rock specimens was conducted with the split Hopkinson pressure bar (SHPB) driven by pendulum hammer, in order to determine the indirect tensile strength of rock under an intermediate strain rate ranging from 5.2 to 12.9 s-1, which is achieved when the incident bar is impacted by pendulum hammer with different velocities. The incident wave excited by pendulum hammer is triangular in shape, featuring a long rising time, and it is considered to be helpful for achieving a constant strain rate in the rock specimen. The dynamic indirect tensile strength of rock increases with strain rate. Then, the numerical simulator RFPA-Dynamics, a well-recognized software for simulating the rock failure under dynamic loading, is validated by reproducing the Brazilian test of rock when the incident stress wave retrieved at the incident bar is input as the boundary condition, and then it is employed to study the Brazilian test of rock under the higher strain rate. Based on the numerical simulation, the strain-rate dependency of tensile strength and failure pattern of the Brazilian disc specimen under the intermediate strain rate are numerically simulated, and the associated failure mechanism is clarified. It is deemed that the material heterogeneity should be a reason for the strain-rate dependency of rock.

  13. Gianotti-Crosti syndrome: a case report of a teenager.

    PubMed

    Pedreira, Renata Leite; Leal, Juliana Martins; Silvestre, Keline Jácome; Lisboa, Alice Paixão; Gripp, Alexandre Carlos

    2016-01-01

    Gianotti-Crosti syndrome is a rare disease characterized by acral papular eruption with symmetrical distribution. It is a benign and self-limited disease; the symptoms disappear after two to eight weeks, without recurrences or scars. Skin lesions are usually asymptomatic. Prodrome might occur, suggesting upper respiratory infection, or constitutional symptoms. Diagnosis is eminently clinical, and this disease is associated with viral infections. Due to its rarity and low occurrence in adolescents and adults, we report a case of Gianotti-Crosti syndrome of a teenager.

  14. Granulomatous slack skin syndrome: Report of a unique case.

    PubMed

    Maheswari, S Uma; Sampath, V; Ramesh, A

    2018-01-01

    Granulomatous slack skin syndrome is a rare variant of cutaneous T-cell lymphoma (mycosis fungoides). It is characterized clinically by redundant skin folds, which show a predilection towards flexural areas such as the axilla and the groin. Histologically, it shows a granulomatous T-cell infiltrate and loss of elastic tissue. It has an indolent but progressive course; and is usually refractory to treatment. We report a unique case of slack skin syndrome, sparing the classical sites with rapid and unusual involvement of non-intertriginous areas.

  15. [Two cases of "scombroid syndrome" with severe cardiovascular compromise].

    PubMed

    Ascione, A; Barresi, L S; Sarullo, F M; De Silvestre, G

    1997-12-01

    Two cases of severe intoxication after ingestion of cooked tuna fish were observed. Symptoms and clinical signs were consistent with the scombroid syndrome. Cardiovascular shock was observed in both patients and was associated with subendocardial myocardial infarction in 1 case and acute pulmonary edema with myocardial ischemia in the other. The importance of ECG monitoring in the Intensive Coronary Care Unit is stressed.

  16. Trigeminal neuralgia post-styloidectomy in Eagle syndrome: a case report

    PubMed Central

    2012-01-01

    Introduction Eagle syndrome is a condition characterized by an elongated (>3cm) styloid process with associated symptoms of recurrent facial or throat pain. In this report we present a case of Eagle syndrome exhibiting the typical findings of glossopharyngeal nerve involvement, as well as unusual involvement of the trigeminal nerve. Notably, this patient developed a classical trigeminal neuralgia post-styloidectomy. Case presentation A 68-year-old Caucasian woman presented with a 25-year history of dull pain along the right side of her throat, lateral neck, and jaw. Her symptoms were poorly controlled with medication until 15 years ago when she was diagnosed with Eagle syndrome, and underwent a manual fracture of her styloid process. This provided symptomatic relief until 5 years ago when the pain recurred and progressed. She underwent a styloidectomy via a lateral neck approach, which resolved the pain once again. However, 6 months ago a new onset of triggerable, electric shock-like facial pain began within the right V1 and V2 distributions. Conclusions Eagle syndrome is distressing to patients and often difficult to diagnose due to its wide variability in symptoms. It is easily confused with dental pain or temporomandibular joint disorder, leading to missed diagnoses and unnecessary procedures. Pain along the jaw and temple is an unusual but possible consequence of Eagle syndrome. An elongated styloid process should be considered a possible etiology of dull facial pain in the trigeminal distributions, in particular V3. PMID:23031688

  17. A case of Gitelman syndrome with severe hyponatraemia and hypophosphataemia.

    PubMed

    Ali, Absar; Masood, Qamar; Yaqub, Sonia; Kashif, Waqar

    2013-01-01

    Gitelman syndrome (GS) is a renal tubular disorder of the thiazide-sensitive sodium chloride cotransporter, which is located in the distal tubule of the loop of Henle. We present a rare case of GS complicated by severe hyponatraemia and hypophosphataemia. A 17-year-old boy was admitted to our institution with fever and lethargy. The workup revealed typical features of GS, i.e. hypokalaemia, hypomagnesaemia and metabolic alkalosis. In this report, we discuss the differential diagnoses and rationale for accepting GS as the most likely diagnosis. This case was complicated by severe hyponatraemia (115 mmol/L) and hypophosphataemia (0.32 mmol/L). We concluded that the syndrome of inappropriate secretion of antidiuretic hormones could not be ruled out and that respiratory alkalosis was the most likely aetiology of hypophosphataemia. This case report also generates an interesting discussion on water and electrolyte metabolism.

  18. [Vascular malformations in the Williams-Beuren syndrome: report of three new cases].

    PubMed

    Sator, Hicham; Rhouni, Fatima Ezzahra; Benjouad, Ibitihale; Rhouni, Fatima Ezzahra; Benjouad, Ibitihale; Dafiri, Rachida; Chat, Latifa

    2016-01-01

    The Williams-Beuren syndrome is a rare genetic disease. It combines classically specific facial dysmorphism, cardiovascular malformations and specific neuropsychological profile. We report three cases of Williams-Beuren syndrome in children with particular emphasis on vascular abnormalities observed on CT angiography and MR angiography.

  19. Gorlin-goltz syndrome: case report of a rare hereditary disorder.

    PubMed

    Agrawal, Ashutosh; Murari, Aditi; Vutukuri, Sunil; Singh, Arun

    2012-01-01

    Introduction. Gorlin-Goltz syndrome is an inherited autosomal dominant disorder with complete penetrance and extreme variable expressivity. Case Report. The present paper highlights the importance of diagnostic criteria and histopathology in early and prompt diagnosis which will lead to proper treatment and genetic counseling of the patient. Discussion. Gorlin-Goltz syndrome is about multisystem process comprising the triad of basal cell nevi, jaw keratocysts, and skeletal anomalies. A spectrum of other neurological, ophthalmic, endocrine and genital manifestations is known to be variably associated with this triad. Diagnosis of the syndrome is based on major and minor criteria. Conclusion. This paper emphasizes the importance of oral and maxillofacial health professionals in the early diagnosis of nevoid basal cell carcinoma syndrome and in a preventive multidisciplinary approach to provide a better prognosis to the patient.

  20. Gorlin-Goltz Syndrome: Case Report of a Rare Hereditary Disorder

    PubMed Central

    Agrawal, Ashutosh; Murari, Aditi; Vutukuri, Sunil; Singh, Arun

    2012-01-01

    Introduction. Gorlin-Goltz syndrome is an inherited autosomal dominant disorder with complete penetrance and extreme variable expressivity. Case Report. The present paper highlights the importance of diagnostic criteria and histopathology in early and prompt diagnosis which will lead to proper treatment and genetic counseling of the patient. Discussion. Gorlin-Goltz syndrome is about multisystem process comprising the triad of basal cell nevi, jaw keratocysts, and skeletal anomalies. A spectrum of other neurological, ophthalmic, endocrine and genital manifestations is known to be variably associated with this triad. Diagnosis of the syndrome is based on major and minor criteria. Conclusion. This paper emphasizes the importance of oral and maxillofacial health professionals in the early diagnosis of nevoid basal cell carcinoma syndrome and in a preventive multidisciplinary approach to provide a better prognosis to the patient. PMID:23050170

  1. Pertussis-like syndrome associated with adenovirus presenting with hyperleukocytosis: Case report

    PubMed Central

    Sarbay, Hakan; Polat, Aziz; Mete, Emin; Balci, Yasemin Isik; Akin, Mehmet

    2016-01-01

    Adenovirus is an infectious viral agent that causes variety of clinical presentations such as respiratory disease, conjunctivitis, and gastroenteritis. Hepatitis, pancreatitis, myocarditis, encephalitis, and disseminated infection are primarily seen in immunocompromised patients. Rarely, adenovirus infection can present with pertussis-like syndrome. Described here is case of pertussis-like syndrome associated with adenovirus presenting with hyperleukocytosis. PMID:28058402

  2. Neurofibromatosis-Noonan syndrome: case report and clinicopathogenic review of the Neurofibromatosis-Noonan syndrome and RAS-MAPK pathway.

    PubMed

    Reig, Irela; Boixeda, Pablo; Fleta, Beatriz; Morenoc, Carmen; Gámez, Lucía; Truchuelo, Mayte

    2011-04-15

    Neurofibromatosis-Noonan syndrome is an entity that combines both features of Noonan syndrome and Neurofibromatosis type 1. This phenotypic overlap can be explained by the involvement of the RAS-MAPK pathway (mitogen-activated protein kinase) in both disorders. We report the case of a 17-year-old boy with Neurofibromatosis 1 with Noonan-like features, who complained of the progressive appearance of blue-gray lesions on his back.

  3. Terson syndrome and leukemia: a case report

    PubMed Central

    Lorenzi, Umberto; Buschini, Elisa; Fea, Antonio; Machetta, Federica; Grignolo, Federico Maria

    2014-01-01

    Background Terson syndrome is defined as intraocular hemorrhage associated with intracranial bleeding. This syndrome can occur in the event of intracranial hemorrhage or elevated intracranial pressure. To our knowledge, it has never been associated with chronic myeloid leukemia. A 45-year-old woman suffering from chronic myeloid leukemia was referred to our clinic with Terson syndrome after intracranial bleeding. We followed this patient for a year, performing visual acuity assessment, fundus examination, color retinography, and A-scan and B-scan ultrasonography. At presentation, her best-corrected visual acuity on the right was 20/63 and on the left was 20/320. In the right eye, retinoscopy showed blurring of the optic margins surrounded by retinal and preretinal hemorrhages, preretinal fibrosis of the optic disc along the vascular arcades, and perivascular retinal infiltrates. In the left eye, the optic disc was surrounded by retinal and preretinal hemorrhages, and massive fibrosis with hard exudates and severe preretinal hemorrhage were observed at the posterior pole. Roth spots and many circular hemorrhages were noted at the periphery of the retina. A-scan and B-scan ultrasonography did not show intraocular leukemic infiltration. The clinical picture remained stable over the following 12 months. In this patient, we observed the ophthalmoscopic features of chronic myeloid leukemia, but also coexistence of features typical of Terson syndrome. To our knowledge, no similar cases have been reported previously. PMID:24729684

  4. Syndromic odontogenic keratocyst: A case report and review of literature

    PubMed Central

    Arshad, Fazil

    2016-01-01

    Odontogenic keratocysts (OKCs) may occur in two different forms, either as solitary (nonsyndromic OKCs) or as multiple OKCs (syndromic OKCs). Multiple OKCs usually occur as one of the findings in Gorlin–Goltz syndrome with other features such as skin carcinomas and rib, eye, and neurologic abnormalities. We report a rare case of Gorlin–Goltz syndrome in a 20-year-old male patient who presented with a slow growing swelling on lower right and left back teeth region since 2 months. Apart from these, other findings were frontal bossing, depressed nasal bridge, ocular hypertelorism, prominent supra orbital ridge, and mild mandibular prognathism. Excision was done and microscopic study revealed OKC and the follow-up could not be carried out for the complete management. We also presented a review of its pathogenesis, criterion, and differences between syndromic and nonsyndromic OKCs and suggest to thoroughly examine any patient who presents with multiple OKCs to rule out syndromic variety. PMID:27011939

  5. [Autoimmune polyglandular syndrome type 2 in pregnancy: a case report].

    PubMed

    Krysiak, Robert; Okopień, Bogusław

    2013-01-01

    Autoimmune polyglandular syndromes are conditions characterized by the association of two or more organ-specific disorders. On the basis of the clinical picture, they are divided into four different types. If undiagnosed and untreated, autoimmune polyglandular syndromes may pose a serious risk to patients. We report here a case of a pregnant woman with autoimmune polyglandular syndrome type 2. She was diagnosed with Addison's disease 11 months before the onset of the pregnancy and until the end of the first trimester the disease was effectively controlled by hydrocortisone and fludrocortisone treatment. In the tenth week of gestation, the patient developed Graves' disease and the treatment with propylthiouracil was started treatment leading to the unmasking of adrenal insufficiency, which required titration of hydrocortisone dose. Our study shows that autoimmune polyglandular syndromes should be considered in every pregnant woman with any autoimmune endocrine disease and that the treatment of these syndromes during gestation may be challenging.

  6. Usher syndrome Type I in an adult Nepalese male: a rare case report.

    PubMed

    Sahu, Sabin; Singh, Sanjay Kumar

    2017-07-01

    Usher syndrome, also known as retinitis pigmentosa-dysacusis syndrome, is an extremely rare genetic disorder, characterized by retinitis pigmentosa (RP) and congenital sensorineural hearing loss. It has been estimated to account for 3-6% of the congenitally deaf population, upto 8-33% of individuals with RP and half of all cases with combined deafness and blindness (Vernon M,1969; Boughman JA et al,1983). The prevalence of Usher syndrome have been reported to range from 3.5 to 6.2 per 100,000 in different populations (Vernon M,1969; Boughman JA et al,1983; Yan D et al, 2010). We report a case of Usher syndrome type I in an adult Nepalese male with typical congenital profound hearing loss, and night blindness secondary to retinitis pigmentosa. © NEPjOPH.

  7. Gorlin and goltz syndrome: a case report with surgical review.

    PubMed

    Namdeoraoji Bahadure, Rakesh; Surendraji Jain, Eesha; P Badole, Gautam

    2013-05-01

    Gorlin and Goltz syndrome are a very complex syndrome and a multisystemic process that is characterized by the presence of multiple pigmented basocellular carcinomas, keratocysts in the jaws, palmar and/or plantar pits and calcification of the falx cerebri. Along with these major features a great number minor features have also been described which involves numerous skeletical, dermatology related, neurological, ophthalmological and reproductive anomalies. It exhibits high penetrance and variable expressivity. Presented here is the case of Gorlin-Goltz in a 12 years old male patient which was diagnosed through its oral and maxillofacial manifestations. Treatment of odontogenic keratocyst was done by enucleation without primary suturing. Iodoform dressing was kept to enhance the healing and to reduce the recurrence of the lesion. It is important to provide the early diagnosis for detection of clinical and radiological manifestations in young patients and for provision of advice concerning preventive treatment like protection of the skin from the sunlight and genetic sensitivity testing so that possible complications associated with this syndrome can be prevented. How to cite this article: Bahadure RN, Jain ES, Badole GP. Gorlin and Goltz Syndrome: A Case Report with Surgical Review. Int J Clin Pediatr Dent 2013;6(2):104-108.

  8. Gorlin and Goltz Syndrome: A Case Report with Surgical Review

    PubMed Central

    Surendraji Jain, Eesha; P Badole, Gautam

    2013-01-01

    ABSTRACT Gorlin and Goltz syndrome are a very complex syndrome and a multisystemic process that is characterized by the presence of multiple pigmented basocellular carcinomas, keratocysts in the jaws, palmar and/or plantar pits and calcification of the falx cerebri. Along with these major features a great number minor features have also been described which involves numerous skeletical, dermatology related, neurological, ophthalmological and reproductive anomalies. It exhibits high penetrance and variable expressivity. Presented here is the case of Gorlin-Goltz in a 12 years old male patient which was diagnosed through its oral and maxillofacial manifestations. Treatment of odontogenic keratocyst was done by enucleation without primary suturing. Iodoform dressing was kept to enhance the healing and to reduce the recurrence of the lesion. It is important to provide the early diagnosis for detection of clinical and radiological manifestations in young patients and for provision of advice concerning preventive treatment like protection of the skin from the sunlight and genetic sensitivity testing so that possible complications associated with this syndrome can be prevented. How to cite this article: Bahadure RN, Jain ES, Badole GP. Gorlin and Goltz Syndrome: A Case Report with Surgical Review. Int J Clin Pediatr Dent 2013;6(2):104-108. PMID:25206202

  9. [The case of an adult man with savant syndrome in the course of autism spectrum disorder].

    PubMed

    Sipowicz, Kasper; Pietras, Tadeusz

    2017-07-21

    The paper reports on a case of 57-year man with autism spectrum disorder and epilepsy with an unusual feature of calendar calculation. Namely, this is the case of savant syndrome, which appears rarely in the course of various neuropsychiatric disorders. Commorbidity of epilepsy and autism particularly predispose to the aforementioned syndrome. In the presented case, apart from the calendar calculation, the man has high language abilities. As previous studies suggest, the extraordinary abilities among persons with savant syndrome works similarly to the language module in healthy persons. Savant syndrome may appear in any patient with neuropsychiatric disorders, particularly in those suffering from autism spectrum disorder with comorbid epilepsy.

  10. Pregnancy complicated with PFAPA (periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis) syndrome: a case report.

    PubMed

    Ota, Kuniaki; Kwak-Kim, Joanne; Takahashi, Toshifumi; Mizunuma, Hideki

    2018-06-04

    Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome has been considered as a childhood syndrome. The underlying etiology of PFAPA syndrome is unclear however, currently considered as auto-immune inflammatory disease. Recently, a few cases of adult-onset of PFAPA syndrome have been reported. However, there is no report about the successful management of pregnancy complicated with PFAPA syndrome. The patient was a 31-year-old woman who developed recurrent episodes of high fever associated with cervical adenitis, pharyngitis and vomiting started 9 months after a delivery. She was diagnosed with PFAPA syndrome and cimetidine 800 mg/day was initiated. Since then, these symptoms got better. Cimetidine treatment was discontinued since she became pregnant (6 weeks of pregnancy). Except one febrile episode at 8 weeks gestation, she did not develop a febrile episode during pregnancy. Peripheral blood Th1/Th2 ratio was decreased from the first trimester to the second trimester of pregnancy. Then again, the ratio was steadily elevated during the third trimester. At 38 weeks, she delivered a live born infant without any complication. Two months after delivery, she developed PFAPA syndrome again and cimetidine treatment was re-initiated. However, febrile episodes were not controlled well, and Th1/Th2 ratio was further elevated compared to pregnancy status. Colchicine 0.5 mg once a day was initiated. Symptoms were diminished and Th1/Th2 ratio was gradually decreased. There was no case report of pregnancy complicated with PFAPA syndrome, though there were several reports of adult-onset PFAPA cases without pregnancy. The current case may be the first case report of a successful pregnancy complicated with PFAPA. In this case, PFAPA symptoms were ameliorated during pregnancy, but reappeared after delivery. We speculate that PFAPA syndrome, a Th1 type immune disorder, might be improved due to the Th1 to Th2 shifting, which was induced by

  11. PRKAR1A-negative familial Cushing's syndrome: two case reports.

    PubMed

    Lim, Lee Ling; Kitan, Normayah; Paramasivam, Sharmila Sunita; Ratnasingam, Jeyakantha; Ibrahim, Luqman; Chan, Siew Pheng; Tan, Alexander Tong Boon; Vethakkan, Shireene Ratna

    2015-12-01

    Determining the etiology of Cushing's syndrome is very challenging to endocrinologists, with most of the difficulty arising from subtype differentiation of adrenocorticotropic hormone-dependent Cushing's syndrome. We present the pitfalls of evaluating a rare cause of adrenocorticotropic hormone-independent Cushing's syndrome in the transition period between adolescence and adulthood. A sibling pair with familial isolated primary pigmented nodular adrenocortical disease is described. The index case, a 20-year-old Chinese woman, presented with premenopausal osteoporosis with T12 compression fracture and young hypertension. Biochemical analysis confirmed adrenocorticotropic hormone-independent Cushing's syndrome (elevated 0800 h plasma cortisol 808 nmol/L with suppressed adrenocorticotropic hormone level <5 pg/ml). Computed tomography of her adrenal glands revealed a 0.7-cm left adrenal hypodense nodule. After a left adrenalectomy, she had residual hypercortisolism (progressive weight gain, new T10 compression fracture, and not glucocorticoid-dependent postoperatively). Completion of contralateral adrenalectomy was performed upon recognition of typical histologic characteristics of primary pigmented nodular adrenocortical disease found in an initial left adrenalectomy specimen. Similarly, her younger brother developed adrenocorticotropic hormone-independent Cushing's syndrome at age 18 years, with typical cushingoid habitus, but no osteoporosis or hypertension. His adrenal computed tomographic scans showed micronodularities over bilateral adrenal glands. He was successfully treated with bilateral adrenalectomy. Screening for Carney's complex and PRKAR1A gene mutation was negative. Signs and symptoms of Cushing's syndrome resolved after bilateral adrenalectomy for both patients. They were placed on lifelong glucocorticoid and mineralocorticoid replacement therapy and long-term surveillance for Carney's complex. The cases of these two patients illustrate the

  12. Acral peeling skin syndrome in two East-African siblings: case report.

    PubMed

    Kiprono, Samson K; Chaula, Baraka M; Naafs, Bernard; Masenga, John E

    2012-03-19

    Acral peeling skin syndrome is a rare autosomal recessive genodermatosis due to a missense mutation in transglutaminase 5. The skin peeling occurs at the separation of the stratum corneum from the stratum granulosum. We present a case of two siblings who developed continuous peeling of the palms and soles from the first year of life. This peeling was more severe on the soles than palms and on younger sibling than elder sibling. Peeling is worsened by occlusion and sweating. Sporadic cases of Acral Peeling Skin Syndrome occur in African population. There is variability in time of presentation and clinical severity even within families.

  13. Stiff-person syndrome: a case report and review of the literature.

    PubMed

    Egwuonwu, Steve; Chedebeau, Fernando

    2010-12-01

    We report a case of stiff-person syndrome associated with several autoimmune diseases. A 49-year-old male with type 1 diabetes presented with a 6-month history of muscle rigidity and spasms of his upper and lower extremities. Anti-glutamic acid decarboxylase 65 antibody was elevated at 609 nmol/L. Electromyography revealed continuous motor unit activity in agonist and antagonist muscles. He responded favorably to diazepam, baclofen, and intravenous immunoglobulin infusions. This case report describes stiff-person syndrome in association with pernicious anemia and diabetes mellitus. A review of the literature discusses the diagnosis and treatment of this rare entity.

  14. Early onset marfan syndrome: Atypical clinical presentation of two cases

    PubMed Central

    Ozyurt, A; Baykan, A; Argun, M; Pamukcu, O; Halis, H; Korkut, S; Yuksel, Z; Gunes, T; Narin, N

    2015-01-01

    Early onset Marfan Syndrome (eoMFS) is a rare, severe form of Marfan Syndrome (MFS). The disease has a poor prognosis and most patients present with resistance to heart failure treatment during the newborn period. This report presents two cases of eoMFS with similar clinical features diagnosed in the newborn period and who died at an early age due to the complications related to the involvement of the cardiovascular system. PMID:26929908

  15. Reiter's syndrome among Asian shipboard immigrants: the case of The Golden Venture.

    PubMed

    Solitar, B M; Lozada, C J; Tseng, C E; Lowe, A M; Krajewski, W M; Blanchard, K; Pillinger, M; Weissmann, G; Weissman, G

    1998-04-01

    To assess the incidence of Reiter's syndrome aboard The Golden Venture, a ship carrying illegal immigrants from China to the United States. After identification of an index case, we conducted telephone interviews with medical staff at immigrant detention centers in Pennsylvania, New York, and Virginia. When a potential case was identified at one facility, we performed a site inspection, reviewing the medical records of all detainees and performing histories and physicals on all those with joint and/or ocular complaints. We identified two patients, both HLA B27 positive, with Reiter's syndrome. The observed incidence (0.87%) approximated the predicted incidence but may have underestimated the actual incidence. We review the history of shipboard Reiter's syndrome, and discuss the pathogenic roles of HLA B27 and particular infectious agents. Continued transportation of illegal immigrants from China and other parts of the world is likely to result in occasional clusters of Reiter's syndrome. Physicians treating immigrant populations should remain aware of the possibility of reactive arthritis.

  16. Psychosis in a Case of Dandy-Walker Syndrome: A Case Report

    PubMed Central

    Dawra, Ripu Daman; Karia, Sagar; Shah, Nilesh

    2017-01-01

    Dandy Walker Syndrome (DWS) is a congenital malformation with brain abnormalities, intellectual disabilities, epilepsy and visible structural changes in particular brain structures. We present here a case of psychosis in an 18-year-old male with DWS, epilepsy and intellectual disability. The purpose of this paper is to discuss the clinically relevant issues, psychopharmacological issues, neuropsychiatric manifestations and consultation liaison issues involved. PMID:28658885

  17. Rhabdomyolysis resulting in concurrent Horner's syndrome and brachial plexopathy: a case report.

    PubMed

    Lee, Susan C; Geannette, Christian; Wolfe, Scott W; Feinberg, Joseph H; Sneag, Darryl B

    2017-08-01

    This case report describes a 29-year-old male who presented with immediate onset of Horner's syndrome and ipsilateral brachial plexopathy after sleeping with his arm dangling outside a car window for 8 h. Outside workup and imaging revealed rhabdomyolysis of the left neck musculature. Subsequent electrodiagnostic testing and high-resolution brachial plexus magnetic resonance imaging at the authors' institution attributed the Horner's syndrome and concurrent brachial plexopathy to rhabdomyolysis of the longus colli and scalene musculature, which had compressed-and consequently scar tethered-the cervical sympathetic trunk and brachial plexus. This case of co-existent Horner's syndrome and brachial plexopathy demonstrates the role of high-resolution brachial plexus MRI in diagnosing plexopathy and the importance of being familiar with plexus and paravertebral muscle anatomy.

  18. A rare case of 46,XX gonadal dysgenesis and Mayer-Rokitansky-Kuster-Hauser syndrome.

    PubMed

    Manne, Sriharibabu; Veeraabhinav, C H; Jetti, Mounica; Himabindu, Yalamanchali; Donthu, Kiranmai; Badireddy, Mutyalarayudu

    2016-01-01

    46,XX gonadal dysgenesis is a rare genetically heterogeneous disorder characterized by underdeveloped ovaries with consequent, impuberism, primary amenorrhea, and hypergonadotropic hypogonadism. Mullerian agenesis or Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by congenital aplasia of the uterus and the upper part (2/3) of the vagina in a woman with normal development of secondary sexual characteristics and a normal 46,XX karyotype. The phenotypic manifestations of MRKH syndrome may sometimes overlap with various other syndromes and require accurate delineation. The coexistence of both these disorders is extremely rare. Here, we report a case of 46,XX gonadal dysgenesis and MRKH syndrome with anatomically dispersed congenital anomalies unique among reported cases.

  19. Guillain-Barré syndrome in pregnancy: A case report.

    PubMed

    Hukuimwe, Misai; Matsa, Tawanda T; Gidiri, Muchabayiwa F

    2017-04-01

    Guillain-Barré syndrome is a rare condition in pregnancy which is characterised by symmetrical progressive ascending polyneuropathy. A case of a 16-year-old nulliparous woman who presented with rapidly progressive limb paralysis following an upper respiratory tract infection a week prior to presentation is discussed. She was intubated as she had developed respiratory failure and managed in the intensive care unit by a multidisciplinary team. Plasma exchange and intravenous immunoglobulin were not readily available so she was managed conservatively. The management of Guillain-Barré syndrome, maternal and foetal outcomes have been discussed.

  20. Shaggy aorta syndrome after acute arterial macroembolism: report of a case.

    PubMed

    Hayashida, Naoki; Murayama, Hirokazu; Pearce, Yoko; Asano, Souichi; Ohashi, Yukio; Kohno, Hiroki; Handa, Takemi; Matsuo, Kozo; Nakagawa, Yasutsugu; Tatsuno, Katsuhiko

    2004-01-01

    We report the case of a patient who underwent treatment for a macroembolism in the right lower leg, which led to shaggy aorta syndrome. Anticoagulant therapy for the macroembolism and intra-aortic catheterization exacerbated the patient's renal function and triggered another massive microembolization of the visceral arteries, with a fatal outcome. To minimize the incremental complications inherent to this syndrome, awareness and prompt diagnosis with enhanced computed tomography or intravenous digital subtraction aortography are essential. Axillo-bifemoral bypass with bilateral external iliac artery ligations, performed with optimal timing, could save patients with shaggy aorta syndrome.

  1. A further case of a Prader-Willi syndrome phenotype in a patient with Angelman syndrome molecular defect.

    PubMed

    De Molfetta, Greice Andreotti; Felix, Temis Maria; Riegel, Mariluce; Ferraz, Victor Evangelista de Faria; de Pina Neto, João Monteiro

    2002-12-01

    Angelman syndrome (AS) and Prader-Willi syndrome (PWS) are distinct human neurogenetic disorders; however, a clinical overlap between AS and PWS has been identified. We report on a further case of a patient showing the PWS phenotype with the AS molecular defect. Despite the PWS phenotype, the DNA methylation analysis of SNRPN revealed an AS pattern. Cytogenetic and FISH analysis showed normal chromosomes 15 and microsatellite analysis showed heterozygous loci inside and outside the 15q11-13 region. The presence of these atypical cases could be more frequent than previously expected and we reinforce that the DNA methylation analysis is important for the correct diagnosis of severe mental deficiency, congenital hypotonia and obesity.

  2. Neuroleptic malignant syndrome: case report and discussion

    PubMed Central

    Chandran, Geethan J.; Mikler, John R.; Keegan, David L.

    2003-01-01

    WE REPORT A CASE INVOLVING AN 81-YEAR-OLD man with schizoaffective disorder who presented with neuroleptic malignant syndrome (NMS) after an increase in his neuroleptic dose. NMS, a rare but potentially fatal complication of neuroleptic medications (e.g., antipsychotics, sedatives and antinauseants), is characterized by hyperthermia, muscle rigidity, an elevated creatine kinase level and autonomic instability. The syndrome often develops after a sudden increase in dosage of the neuroleptic medication or in states of dehydration. Treatment is mainly supportive and includes withdrawal of the neuroleptic medication and, possibly, administration of drugs such as dantrolene and bromocriptine. Complications of NMS include acute renal failure and acute respiratory failure. Given the widespread prescription of neuroleptics by physicians in a variety of fields, all physicians need to be able to recognize and appropriately manage NMS. PMID:12952806

  3. Prune Belly syndrome: A rare case report

    PubMed Central

    Samal, Sunil Kumar; Rathod, Setu

    2015-01-01

    Prune Belly syndrome (PBS) is a rare congenital anomaly of uncertain etiology almost exclusive to males. We report a case of term male baby born to a 39-year-old grand multipara with previous four normal vaginal births. There was no history of genetic or congenital anomaly in her family. Examination of the baby revealed hypotonia, deficient abdominal muscle, cryptorchidism, palpable kidney, and bladder. Ultrasound examination of the abdomen revealed bilateral gross hydronephrosis and megaureter. Provisional diagnosis of PBS was made and the baby was admitted in neonatal intensive care units for further management. Routine antenatal care with ultrasonography will help in detecting renal anomalies, which can be followed postnatally. Early diagnosis of this syndrome and determining its optimal treatment are very important in helping to avoid its fatal course. PMID:25810678

  4. Cotard's syndrome: analysis of 100 cases.

    PubMed

    Berrios, G E; Luque, R

    1995-03-01

    In 1880, Jules Cotard reported a clinical state he believed was a new type of agitated melancholia. A statistical analysis has been carried out of 100 cases of Cotard's syndrome to determine how this clinical concept has fared since its inception. In terms of clinical profile, no difference was found between men and women or between underlying diagnostic categories; age seemed to increase the likelihood of developing délire des négations. Depression was reported in 89% of subjects; the most common nihilistic delusions concerned the body (86%) and existence (69%). Anxiety (65%) and guilt (63%) were also common, followed by hypochondriacal delusions (58%) and delusions of immortality (55). An exploratory factor analysis extracted 3 factors: psychotic depression, Cotard type I and Cotard type II. The psychotic depression factor included patients with melancholia and few nihilistic delusions. Cotard type 1 patients, on the other hand, showed no loadings for depression or other disease and are likely to constitute a pure Cotard syndrome whose nosology may be closer to the delusional than the affective disorders. Type II patients showed anxiety, depression and auditory hallucinations and constitute a mixed group. This new grouping cuts across the more traditional view and may have therapeutic implications. Authors, in general, have considered délire des négations as a syndrome rather than a new disease and do not seem to support the view that the completeness of the syndrome is a function of presence or severity of depression. The view that délire des négations refers only to the delusion of being dead has also carried little favour as its likely to waste information.

  5. A case of vascular Ehlers-Danlos Syndrome with a cardiomyopathy and multi-system involvement.

    PubMed

    Lan, Nick Si Rui; Fietz, Michael; Pachter, Nicholas; Paul, Vincent; Playford, David

    Ehlers-Danlos Syndrome comprises a heterogeneous group of heritable connective tissue disorders resulting from various gene mutations. We present an unusual case of vascular Ehlers-Danlos Syndrome with distinctive physical characteristics and a cardiomyopathy with features suggesting isolated left ventricular non-compaction. The cardiac features represent the first report of a cardiomyopathy associated with a mutation in the COL3A1 gene. This case also illustrates the multi-system nature of Ehlers-Danlos Syndrome and the complexity of managing patients with the vascular subtype. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Fetal Therapy for Down Syndrome: Report of Three Cases and a Review of the Literature.

    PubMed

    Baggot, Patrick James; Baggot, Rocel Medina

    2017-01-01

    Down syndrome (trisomy 21) is a well-known cause of mental retardation. It can be diagnosed in early pregnancy. Scientists have made great strides in outlining the pathophysiologic mechanisms of mental retardation in Down syndrome. Much less has been published on human therapy. To our knowledge, these are the first published cases of fetal therapy for Down syndrome. Reports of three cases. In all cases, treatment was both biochemical (e.g. nutritional) and educational. In all cases, treatment was both before and after birth. All children lacked the characteristic faces usually seen in the children with Down syndrome. This suggests a treatment effect before birth. All children had better than expected development. Enhancement of development is proposed as a new therapeutic principle. Developing neurons exchange neurotrophic factors during development when they give or receive stimulation from other neurons. Neurons which receive neurotrophic stimulation survive, and those, which do not, are lost to apoptosis. The developmental therapeutic principle seeks to optimize brain development. Biochemical inputs (neurotransmitters, drugs, hormones, nutrients) and functional stimulation are integrated to optimize the growth and survival of neurons individually; other cells; subcellular organelles; and the brain as a whole. Treatment may be before and after birth, both biochemical and functional. These principles may be applied to Down syndrome, other conditions, and normal fetuses or children. Baggot PJ and Baggot RM (2014). Fetal Therapy for Down Syndrome: Report of three cases and review of the literature. J Am Phys Surg 19(1):20-24.

  7. Drug-induced Fanconi syndrome associated with fumaric acid esters treatment for psoriasis: a case series.

    PubMed

    Balak, Deepak M W; Bouwes Bavinck, Jan Nico; de Vries, Aiko P J; Hartman, Jenny; Neumann, Hendrik A Martino; Zietse, Robert; Thio, Hok Bing

    2016-02-01

    Fumaric acid esters (FAEs), an oral immunomodulating treatment for psoriasis and multiple sclerosis, have been anecdotally associated with proximal renal tubular dysfunction due to a drug-induced Fanconi syndrome. Few data are available on clinical outcomes of FAE-induced Fanconi syndrome. Descriptive case series with two cases of Fanconi syndrome associated with FAE treatment diagnosed at two Dutch university nephrology departments, three cases reported at the Dutch and German national pharmacovigilance databases and six previously reported cases. All 11 cases involved female patients with psoriasis. The median age at the time of onset was 38 years [interquartile range (IQR) 37-46]. Patients received long-term FAEs treatment with a median treatment duration of 60 months (IQR 28-111). Laboratory tests were typically significant for low serum levels of phosphate and uric acid, while urinalysis showed glycosuria and proteinuria. Eight (73%) patients had developed a hypophosphataemic osteomalacia and three (27%) had pathological bone fractures. All patients discontinued FAEs, while four (36%) patients were treated with supplementation of phosphate and/or vitamin D. Five (45%) patients had persisting symptoms despite FAEs discontinuation. FAEs treatment can cause drug-induced Fanconi syndrome, but the association has been reported infrequently. Female patients with psoriasis treated long term with FAEs seem to be particularly at risk. Physicians treating patients with FAEs should be vigilant and monitor for the potential occurrence of Fanconi syndrome. Measurement of the urinary albumin:total protein ratio is a suggested screening tool for tubular proteinuria in Fanconi syndrome.

  8. Crossing the other side of the algorithm: a challenging case of adrenal Cushing's syndrome.

    PubMed

    Antonio, Imelda Digna Soberano; Sandoval, Mark Anthony Santiago; Lantion-Ang, Frances Lina

    2011-12-01

    The diagnosis of endogenous Cushing's syndrome and its aetiology involved documenting the hypercotisolism and then determining whether that hypercortisolism is adrenocorticotropic hormone-dependent (ACTH-dependent) or not. Hence, following the algorithm, an undetected ACTH level points to an adrenal Cushing's while a detectable or elevated ACTH level points to either a pituitary or ectopic Cushing's syndrome. The authors present a case of florid adrenal Cushing's syndrome initially presenting with a normal ACTH level, which led to the investigation for an ACTH-secreting tumour. Adding to the confusion, a MRI done showed an intrasellar focus. Knowledge of how ACTH-dependent (versus ACTH-independent) Cushing's syndrome manifests clinically, supported by results of repeat laboratory tests, led to the true diagnosis. This case illustrates that a detectable ACTH does not rule out an adrenal Cushing's syndrome nor does a positive pituitary imaging confirm Cushing's disease.

  9. Klinefelter syndrome and acute basophilic leukaemia--case report.

    PubMed

    Ljubić, Nives; Lang, Nada; Skelin, Ika Kardum; Lasan, Ruzica; Dominis, Mara; Perković, Leila; Zupanić-Krmek, Dubraka; Grgurević-Batinica, Anita

    2010-06-01

    Patients with 47, XXY karyotype (Klinefelter syndrome) appear to have increased risk of developing cancer, especially male breast cancer, germ cell tumours and non Hodgkin lymphomas, but rarely acute myeloid leukaemia. We report a patient with acute basophilic leukaemia with 47, XXY karyotype in both the tumour and constitutional cells. Acute basophilic leukaemia is very rare disease comprising less than 1% of all acute myeloid leukaemias. Morphological characteristic of leukaemic blast cells is moderately basophilic cytoplasm containing a variable number of coarse basophilic granules. The most characteristic cytochemical reaction is metachromatic positivity with toluidine blue. Blast are myeloperoxidase negative. Also leukemic blasts express myeloid and monocyte markers. There is no consistent chromosomal abnormality identified in this leukaemia. This is the first reported case of acute basophilic leukaemia in patient with Klinefelter syndrome. In this article the medical history of the patient is given and the possible connection between Klinefelter syndrome and acute myeloid leukaemia is discussed.

  10. Atypical Hallerman-Streif syndrome: a case report.

    PubMed

    Gopakumar, Manju; Hedge, Amitha M

    2005-01-01

    Hallerman Streif syndrome is a rare congenital disorder characterized by dyscephaly, dental anomalies, proportionate nazism, hypotrichosis, cutaneous atrophy limited to the head, bilateral congenital cataracts and bilateral microphthalmia. Despite the marked craniofacial characteristics and oral findings, a relative lack of reports in the dental literature has been noted. In this article, a case of a 8 year old boy with dental problems is described.

  11. Syncope as initial symptom for nephrotic syndrome: a case report

    PubMed Central

    Wu, Xuemei; Wang, Guangliang; Feng, Jiachun

    2015-01-01

    Although syncope and nephrotic syndrome are frequently encountered independently in pediatric practice, syncope as the initial symptom for nephrotic syndrome is rarely observed in the pediatric age group. In this report, we present the case of 3-year-old boy with nephrotic syndrome who presented with a history of three episodes of syncope before admission. The syncope occurred after excessive fluid loss or inadequate intake of fluids and was relieved spontaneously. History taking revealed that the early morning palpebral edema, and laboratory tests showed decreased plasma protein levels and elevated serum lipid levels. Nephrotic syndrome was diagnosed, but could not be confirmed histopathologically because the patient’s parent refused consent for biopsy. The patient was managed with fluid expansion, correction of acidosis, and improvement of microcirculation to prevent recurrence of syncope, and glucocorticoids were administered to prevent disease progression. PMID:26629237

  12. Dental management of patient with Williams Syndrome - A case report.

    PubMed

    Wong, Daniel; Ramachandra, Srinivas Sulugodu; Singh, Ashish Kumar

    2015-01-01

    Williams syndrome is a multisystemic rare genetic disorder caused by deletion of 26-28 genes in the long arm of chromosome 7. It is characterized by developmental and physical abnormalities including congenital cardiovascular abnormalities, mental retardation, neurological features, growth deficiency, genitourinary manifestations, gastrointestinal problems, musculoskeletal problems, unique behavioral characteristics, and dental problems. Dental abnormalities include malocclusion, hypodontia, malformed teeth, taurodontism, pulp stones, increased space between teeth, enamel hypoplasia, and high prevalence of dental caries. Authors report a 17-year-old female patient with underlying Williams syndrome. Oral features and problems seen in the patient are listed. Malocclusion and screwdriver shaped teeth were noticed. Generalized widening of the periodontal ligament space with vital teeth was seen. This finding has not been reported in cases of Williams syndrome earlier. Precautions taken during dental treatment in patients with Williams syndrome are also discussed.

  13. Refeeding syndrome in adults with celiac crisis: a case report.

    PubMed

    Hammami, Sonia; Aref, Houda Lazreg; Khalfa, Messouda; Kochtalli, Ines; Hammami, Mohamed

    2018-01-31

    Refeeding syndrome is a rare and life-threatening pathology with polyvisceral manifestations occurring in severely malnourished patients. It is rarely described in adults with celiac disease. We report the case of a 28-year-old Tunisian woman followed up for celiac disease, who did not adhere to the gluten-free diet. She presented to our hospital with celiac crisis manifested by severe diarrhea, and metabolic and electrolyte disturbances. The treatment of electrolyte abnormalities, hydration, and nutritional support was marked by the occurrence on the fifth day of refeeding syndrome with psychomotor agitation followed by respiratory distress and a state of cardiogenic shock. Refeeding syndrome is still under-recognized. It should be systematically prevented for high-risk patients. Nutritional support in patients with celiac crisis should be monitored carefully since the risk of refeeding syndrome is very high with a poor prognosis.

  14. Multiple cavernous malformations presenting in a patient with Poland syndrome: A case report

    PubMed Central

    2011-01-01

    Introduction Poland syndrome is a congenital disorder related to chest and hand anomalies on one side of the body. Its etiology remains unclear, with an ipsilateral vascular alteration (of unknown origin) to the subclavian artery in early embryogenesis being the currently accepted theory. Cavernous malformations are vascular hamartomas, which have been linked to a genetic etiology, particularly in familial cases, which commonly present with multiple lesions. Our case report is the first to describe multiple cavernous malformations associated with Poland syndrome, further supporting the vascular etiology theory, but pointing to a genetic rather than a mechanistic factor disrupting blood flow in the corresponding vessels. Case presentation A 41-year-old Caucasian man with Poland syndrome on the right side of his body presented to our hospital with a secondary generalized seizure and was found to have multiple cavernous malformations distributed in his brain, cerebellum, and brain stem, with a predominance of lesions in the left hemisphere. Conclusion The distribution of cavernous malformations in the left hemisphere and the right-sided Poland syndrome in our patient could not be explained by a mechanistic disruption of one of the subclavian arteries. A genetic alteration, as in familial cavernous malformations, would be a more appropriate etiologic diagnosis of Poland syndrome in our patient. Further genetic and pathological studies of the involved blood vessels in patients with Poland syndrome could lead to a better understanding of the disease. PMID:21933407

  15. Lumbar vertebral hemangioma causing cauda equina syndrome: a case report.

    PubMed

    Ahn, Henry; Jhaveri, Subir; Yee, Albert; Finkelstein, Joel

    2005-11-01

    Case report. To report a case of lumbar hemangioma causing neurogenic claudication and early cauda equina, managed with hemostatic vertebroplasty and posterior decompression. This is the first report to our knowledge of a lumbar hemangioma causing neurogenic claudication and early cauda equina syndrome. Most hemangiomas causing neurologic symptoms occur in thoracic spine and cause spinal cord compression. Vertebroplasty as a method of hemostasis and for providing mechanical stability in this situation has not been discussed previously in the literature. L4 hemangioma was diagnosed in a 64-year-old woman with severe neurogenic claudication and early cauda equina syndrome. Preoperative angiograms showed no embolizable vessels. Posterior decompression was performed followed by bilateral transpedicular vertebroplasty. The patient received postoperative radiation to prevent recurrence. Complete relief of neurogenic claudication and cauda equina with less than 100 mL of blood loss. A lumbar hemangioma of the vertebral body, although rare, can cause neurogenic claudication and cauda equina syndrome. Intraoperative vertebroplasty can be an effective method of hemostasis and provide stability of the vertebra following posterior decompression.

  16. Prehospital Dextrose Extravasation Causing Forearm Compartment Syndrome: A Case Report.

    PubMed

    Chinn, Matthew; Colella, M Riccardo

    2017-01-01

    A 57-year-old woman was found at home by paramedics to be hypoglycemic with altered mental status. She had multiple attempts at IV access and eventually a 22G IV was established and D50 was infused into her right forearm. Extravasation of the dextrose was noted after approximately 12 g of the medication was infused. She was given a dose of glucagon intramuscularly and her mental status improved. Shortly after her arrival to the emergency department, she was noted to have findings of compartment syndrome of her forearm at the site of the dextrose extravasation. She was evaluated by plastic surgery and taken to the operating room for emergent fasciotomy. She recovered well from the operation. D50 is well known to cause phlebitis and local skin necrosis as a complication. This case illustrates the danger of compartment syndrome after D50 extravasation. It is the first documented case of prehospital dextrose extravasation leading to compartment syndrome. There may be safer alternatives to D50 administration and providers must be acutely aware to monitor for D50 infusion complications.

  17. Pseudohypoparathyroidism with Hashimoto's thyroiditis and Turner syndrome: a case report.

    PubMed

    Zeng, Wen-Heng; Xu, Jiao-Jun; Jia, Min-Yue; Ren, Yue-Zhong

    2014-10-01

    To report the case of an individual with PHP, Turner syndrome and Hashimoto's thyroiditis. A 16-year-old girl was referred to our hospital with chief complaint of short stature. She presented with round chubby facies, short neck, obesity and short stature. Radiography indicated short metatarsals and metacarpals, which mainly affected the second, third and fourth digits. Biochemistry revealed hyperphosphatemia, increased serum concentrations of parathyroid hormone and thyroid stimulating hormone, elevated levels of follicular-stimulating hormone and prolactin, and increased thyroid peroxidase antibody and thyroglobulin antibody. Radiographic examination revealed delayed bone age and pelvic ultrasonography demonstrated an immature uterus. Karyotype analysis showed 46,X,i(Xq10), while molecular analysis revealed a same sense mutation in exon 5 of GNAS (ATC → ATT, Ile).The specific diagnosis was made of Turner syndrome in the presence of Hashimoto's thyroiditis and PHP. She was treated with calcium supplementation, calcitriol and thyroxine. This is the first case report to describe a combination of Turner syndrome with these other clinical entities, and their co-existence should be considered and further investigated.

  18. [Kindler syndrome: clinical and ultra-structural particularities, a propos of three cases].

    PubMed

    El Fekih, Nadia; Mahfoudh, Anis; Zekri, Samy; Kharfi, Monia; Fazaa, Bécima; Jaafoura, Mohamed Habib; Kamoun, Mohamed Ridha

    2011-08-01

    Kindler's syndrome is a rare type of genetic skin condition belonging to the class of bullous poikilodermia. We report three new sibling cases of this rare syndrome. The condition was seen in three sisters aged 12, 16 and 20 years, born of a first-degree consanguineous marriage with no family history of Kindler's syndrome. The three patients presented spontaneously regressive bullous eruptions, poikilodermia of gradual onset, major cutaneous atrophy on the back of the hands and the feet, photosensitivity and gingival hypertrophy. Electron microscopy examination of poikilodermic skin showed normal anchoring filaments and intraepidermal cleavage. Diagnosis of Kindler's syndrome is based upon clinical evidence. Kidler's syndrome is a well defined clinical entity. Ultra-structural studies show intraepidermal, junctional, and dermal cleavage. This syndrome must be differentiated from congenital epidermolysis bullosa, Weary's syndrome, and other bullous hereditary poikilodermas. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  19. Unusual case of failure to thrive: Type III Bartter syndrome.

    PubMed

    Agrawal, S; Subedi, K; Ray, P; Rayamajhi, A

    2016-09-01

    Bartter syndrome Type III is a rare autosomal recessive disorder resulting from an inherited defect in the thick ascending limb of the loop of henle of the nephrons in kidney. The typical clinical manifestations in childhood are failure to thrive and recurrent episodes of vomiting. Typical laboratory findings which help in the diagnosis are hypokalemic metabolic alkalosis, hypomagnesemia and hypercalciuria. We report a case of Type III Bartter syndrome not responding to repeated conventional treatment of failure to thrive.

  20. Treatment of Hyperthyroidism in Down Syndrome: Case Report and Review of Literature.

    ERIC Educational Resources Information Center

    Ali, Fawzi E.; Al-Busairi, Waleed A.; Al-Mulla, Fatema A.

    1999-01-01

    A case of an institutionalized adult male with Down syndrome and hyperthyroidism is reported. After treatment with radioactive iodine, he was found to be markedly hypothyroid when he was reviewed 11 weeks later. Three treatment options for hyperthyroidism in Down syndrome are reviewed: surgery, medical treatments, and radiotherapy. (Author/CR)

  1. Catatonia, Neuroleptic Malignant Syndrome, and Cotard Syndrome in a 22-Year-Old Woman: A Case Report

    PubMed Central

    Weiss, C.; Santander, J.; Torres, R.

    2013-01-01

    The following case study describes a 22-year-old woman with depression and symptoms of psychosis who developed neuroleptic malignant syndrome after using Risperidone, thus requiring life support equipment and Bromocriptine, later recovering after seven days. From a psychiatric and neurological point of view, however, the persistence of catatonic syndrome and Cotard syndrome delusions was observed, based on assertions such as “I do not have a heart,” “my heart is not beating,” “I can not breathe,” “I am breaking apart,” “I have no head” (ideas of negation) and statements about the patient being responsible for the “death of the whole world” (ideas of enormity). Brain NMR revealed leukoencephalopathy, interpreted as scar lesions caused by perinatal neurological damage, after discarding other pathologies. The patient responded well to electroconvulsive therapy after 11 sessions. Organic vulnerability to these syndromes, as well as their coexistence and clinical differentiation is discussed in the light of the data observed. PMID:24093068

  2. Catatonia, neuroleptic malignant syndrome, and cotard syndrome in a 22-year-old woman: a case report.

    PubMed

    Weiss, C; Santander, J; Torres, R

    2013-01-01

    The following case study describes a 22-year-old woman with depression and symptoms of psychosis who developed neuroleptic malignant syndrome after using Risperidone, thus requiring life support equipment and Bromocriptine, later recovering after seven days. From a psychiatric and neurological point of view, however, the persistence of catatonic syndrome and Cotard syndrome delusions was observed, based on assertions such as "I do not have a heart," "my heart is not beating," "I can not breathe," "I am breaking apart," "I have no head" (ideas of negation) and statements about the patient being responsible for the "death of the whole world" (ideas of enormity). Brain NMR revealed leukoencephalopathy, interpreted as scar lesions caused by perinatal neurological damage, after discarding other pathologies. The patient responded well to electroconvulsive therapy after 11 sessions. Organic vulnerability to these syndromes, as well as their coexistence and clinical differentiation is discussed in the light of the data observed.

  3. X-derived marker chromosome in patient with mosaic Turner syndrome and Dandy-Walker syndrome: a case report.

    PubMed

    Telepova, Alena S; Romanenko, Svetlana A; Lemskaya, Natalya A; Maksimova, Yulia V; Shorina, Asia R; Yudkin, Dmitry V

    2017-01-01

    Small supernumerary marker chromosomes can be derived from autosomes and sex chromosomes and can accompany chromosome pathologies, such as Turner syndrome. Here, we present a case report of a patient with mosaic Turner syndrome and Dandy-Walker syndrome carrying a marker chromosome. We showed the presence of the marker chromosome in 33.8% of blood cells. FISH of the probe derived from the marker chromosome by microdissection revealed that it originated from the centromeric region of chromosome X. Additionally, we showed no telomeric sequences and no XIST sequence in the marker chromosome. This is the first report of these two syndromes accompanied by the presence of a marker chromosome. Marker chromosome was X-derived and originated from centromeric region. Patient has mild symptoms but there is no XIST gene in marker chromosome. CPG137. Registered 03 March 2017.

  4. A Boy with a Mild Case of Cornelia de Lange Syndrome with Above Average Intelligence.

    ERIC Educational Resources Information Center

    Lacassie, Yves; Bobadilla, Olga; Cambias, Ron D., Jr.

    1997-01-01

    Describes the characteristics of an 11-year-old boy who represents the only documented case of an individual with Cornelia de Lange syndrome who also has above average cognitive functioning. Major diagnostic criteria for de Lange syndrome and comparisons with other severe and mild cases are discussed. (Author/CR)

  5. [Pigmentosum retinis and tubulo-interstitial nephronophtisis in Sensenbrenner syndrome: a case report].

    PubMed

    Costet, C; Betis, F; Bérard, E; Tsimaratos, M; Sigaudy, S; Antignac, C; Gastaud, P

    2000-02-01

    Sensenbrenner syndrome or cranio-ectodermal dysplasia is an extremely rare autosomal recessive condition (12 cases reported in literature). Our observation shows the possibility of both ocular and renal involvement associated with cranio-ectodermal abnormalities. and method:We report the case of a girl who presented a typical cranio-ectodermal syndrome with dolicocephaly, short thorax, short limbs, short fingers and teeth abnormalities. At five years, she was found to have pigmentosum retinitis with amblyopy and moderate hyperopia. A chronic renal failure with uncontrollable hypertension underwent a cadaveric-donor transplantation at the age of six years. Two years later, the pigmentosum retinitis was stable. The kidney histology revealed a tubulo-interstitial nephronophtisis. The molecular analysis of the NPH 1 locus, which was associated with nephronophtisis, was negative. Our observation and two recent publications have in common ocular and renal abnormalities associated with cranio-ectodermal dysplasia. The underlying genetic defect would involve not only morphogenesis but also development and maturation of organs as eye and kidney. Sensenbrenner syndrome would thus be similar to certain disorders affecting the eye, kidney, skeleton and ectodermal structures such as the EEM, Senior-Loken, Mainzer-Saldino, and Jeune syndromes. The retinal dystrophy falls within the spectrum of clinical and genetic forms of pigmentosum retinitis. Our observation would confirm possible links between Sensenbrenner syndrome and oculorenal syndromes.

  6. Facial peeling skin syndrome: a case report and a brief review.

    PubMed

    Janjua, Shahbaz Ahmad; Hussain, Ijaz; Khachemoune, Amor

    2007-03-01

    Peeling skin syndrome is an extremely rare genodermatosis of possible autosomal recessive inheritance, characterized by asymptomatic spontaneous exfoliation of the stratum corneum at a subcorneal or intracorneal level. It usually presents at birth or appears later in early childhood. The condition may be generalized or localized. Here we describe a case of localized continual skin peeling limited to the facial skin in a 6-month-old infant, with two other members of the family affected with the same condition. A few cases of localized skin peeling limited to the acral surfaces have been described in the literature, but a familial case of localized skin peeling limited to the facial skin has not been described before. We believe that our patient represents a new subtype of peeling skin syndrome, limited to the skin of the face.

  7. [Respiratory manifestations of yellow nail syndrome: report of two cases and literature review].

    PubMed

    Li, S; Huang, H; Xu, K; Xu, Z J

    2018-03-12

    Objective: To describe the clinical characteristics of respiratory manifestations of yellow nail syndrome. Methods: We conducted a retrospective analysis of 2 patients with respiratory diseases associated with yellow nail syndrome. Their clinical and chest radiological data were collected. We searched PubMed, Wanfang and CNKI databases with the keywords "yellow nail syndrome, yellow nail and lung" in Chinese and English. And the relevant literatures, including 6 articles in Chinese and 81 articles in English, were reviewed. Results: Our 2 patients were male, one 60 years old and the other 76. Typical yellow nails were present in their fingers, and one of them also showed toe yellow nails. One patient was admitted for refractory respiratory infection and he was diagnosed with diffuse bronchiectasis. The respiratory symptoms could be relieved with antibiotics according to the results of sputum microbiological analysis. The other patient was admitted for cough and exertional dyspnea, and refractory pleural effusions were revealed bilaterally. He received repeated effusion drainage by thoracentesis, and Octreotide was tried recently. A total of 373 cases were reviewed in Chinese and English literatures. Pleural effusions (152 cases) and diffuse bronchiectasis (121 cases) were the most common reported respiratory manifestations. Lymphoedema was present in almost all cases with pleural effusion associated with yellow nail syndrome, and the effusion was usually exudative and lymphocyte predominant. Pleurodesis and decortication were effective for them. But, somatostatin analogues had been tried effectively for these patients recently. On the other hand, literatures showed that diffuse bronchiectasis in yellow nail syndrome was less severe than idiopathic diffuse bronchiectasis, and might benefit from long-term macrolide antibiotics. Conclusions: Yellow nail syndrome is a very rare disorder. Besides yellow nail, respiratory manifestations are the main clinical

  8. Drug-induced Fanconi syndrome associated with fumaric acid esters treatment for psoriasis: a case series

    PubMed Central

    Balak, Deepak M.W.; Bouwes Bavinck, Jan Nico; de Vries, Aiko P.J.; Hartman, Jenny; Neumann, Hendrik A. Martino; Zietse, Robert; Thio, Hok Bing

    2016-01-01

    Background Fumaric acid esters (FAEs), an oral immunomodulating treatment for psoriasis and multiple sclerosis, have been anecdotally associated with proximal renal tubular dysfunction due to a drug-induced Fanconi syndrome. Few data are available on clinical outcomes of FAE-induced Fanconi syndrome. Methods Descriptive case series with two cases of Fanconi syndrome associated with FAE treatment diagnosed at two Dutch university nephrology departments, three cases reported at the Dutch and German national pharmacovigilance databases and six previously reported cases. Results All 11 cases involved female patients with psoriasis. The median age at the time of onset was 38 years [interquartile range (IQR) 37–46]. Patients received long-term FAEs treatment with a median treatment duration of 60 months (IQR 28–111). Laboratory tests were typically significant for low serum levels of phosphate and uric acid, while urinalysis showed glycosuria and proteinuria. Eight (73%) patients had developed a hypophosphataemic osteomalacia and three (27%) had pathological bone fractures. All patients discontinued FAEs, while four (36%) patients were treated with supplementation of phosphate and/or vitamin D. Five (45%) patients had persisting symptoms despite FAEs discontinuation. Conclusions FAEs treatment can cause drug-induced Fanconi syndrome, but the association has been reported infrequently. Female patients with psoriasis treated long term with FAEs seem to be particularly at risk. Physicians treating patients with FAEs should be vigilant and monitor for the potential occurrence of Fanconi syndrome. Measurement of the urinary albumin:total protein ratio is a suggested screening tool for tubular proteinuria in Fanconi syndrome. PMID:26798466

  9. Guillain-Barré syndrome in pregnancy: A case report

    PubMed Central

    Hukuimwe, Misai; Matsa, Tawanda T; Gidiri, Muchabayiwa F

    2017-01-01

    Guillain-Barré syndrome is a rare condition in pregnancy which is characterised by symmetrical progressive ascending polyneuropathy. A case of a 16-year-old nulliparous woman who presented with rapidly progressive limb paralysis following an upper respiratory tract infection a week prior to presentation is discussed. She was intubated as she had developed respiratory failure and managed in the intensive care unit by a multidisciplinary team. Plasma exchange and intravenous immunoglobulin were not readily available so she was managed conservatively. The management of Guillain-Barré syndrome, maternal and foetal outcomes have been discussed. PMID:28438080

  10. Dandy-Walker syndrome: a review of fifteen cases evaluated by prenatal sonography.

    PubMed

    Russ, P D; Pretorius, D H; Johnson, M J

    1989-08-01

    Fifteen cases of the Dandy-Walker syndrome evaluated by prenatal sonography were reviewed retrospectively. A posterior fossa cyst communicating with the fourth ventricle was a feature in each case. Hydrocephalus was present in 53% of fetuses. Extracranial congenital malformations were documented in 60% of cases. Cardiac, genitourinary, gastrointestinal, and skeletal anomalies were noted. Of 12 available karyotypes, 4 (33%) were abnormal, including two cases of trisomy 18. Excluding terminated pregnancies, there was an overall mortality of 55%. Associated congenital defects contributed to 83% of the postnatal deaths. The Dandy-Walker syndrome can be accurately diagnosed in utero by sonographic demonstration of characteristic morphologic changes in the fetal posterior fossa. The prenatal examination should include an evaluation of associated supratentorial and extracranial defects. Coexisting structural and chromosomal anomalies occur frequently and adversely affect survival.

  11. Kabuki syndrome: a Chinese case series and systematic review of the spectrum of mutations.

    PubMed

    Liu, Shuang; Hong, Xiafei; Shen, Cheng; Shi, Quan; Wang, Jian; Xiong, Feng; Qiu, Zhengqing

    2015-04-21

    Kabuki syndrome is a rare hereditary disease affecting multiple organs. The causative genes identified to date are KMT2D and KDMA6. The aim of this study is to evaluate the clinical manifestations and the spectrum of mutations of KMT2D. We retrospectively retrieved a series of eight patients from two hospitals in China and conducted Sanger sequencing for all of the patients and their parents if available. We also reviewed the literature and plotted the mutation spectrum of KMT2D. The patients generally presented with typical clinical manifestations as previously reported in other countries. Uncommon symptoms included spinal bifida and Dandy-Walker malformation. With respect to the mutations, five mutations were found in five patients, including two frameshift indels, one nonsense mutation and two missense mutations. This is the first case series on Kabuki syndrome in Mainland China. Unusual symptoms, such as spinal bifida and Dandy-Walker syndrome, suggested that neurological developmental defects may accompany Kabuki syndrome. This case series helps broaden the mutation spectrum of Kabuki syndrome and adds information regarding the manifestations of Kabuki syndrome.

  12. Thyroid cancer in a patient with Lynch syndrome - case report and literature review.

    PubMed

    Fazekas-Lavu, Monika; Parker, Andrew; Spigelman, Allan D; Scott, Rodney J; Epstein, Richard J; Jensen, Michael; Samaras, Katherine

    2017-01-01

    Lynch syndrome describes a familial cancer syndrome comprising germline mutations in one of four DNA mismatch repair genes, MLH1 , MSH2 , MSH6 , and PMS2 and is characterized by colorectal, endometrial, and other epithelial malignancies. Thyroid cancer is not usually considered to be part of the constellation of Lynch syndrome cancers nor have Lynch syndrome tumor gene mutations been reported in thyroid malignancies. This study reports a woman with Lynch syndrome (colonic cancer and a DNA mismatch repair mutation in the MSH2 gene) with a synchronous papillary thyroid cancer. Six years later, she developed metachronous breast cancer. Metastatic bone disease developed after 3 years, and the disease burden was due to both breast and thyroid diseases. Despite multiple interventions for both metastatic breast and thyroid diseases, the patient's metastatic burden progressed and she died of leptomeningeal metastatic disease. Two prior case reports suggested thyroid cancer may be an extraintestinal malignancy of the Lynch syndrome cancer group. Hence, this study examined the genetic relationship between the patient's known Lynch syndrome and her thyroid cancer. The thyroid cancer tissue showed normal expression of MSH2 , suggesting that the tumor was not due to the oncogenic mutation of Lynch syndrome, and molecular analysis confirmed BRAF V600E mutation. Although in this case the thyroid cancer was sporadic, it raises the importance of considering cancer genetics in familial cancer syndromes when other cancers do not fit the criteria of the syndrome. Careful documentation of other malignancies in patients with thyroid cancer and their families would assist in better understanding of any potential association. Appropriate genetic testing will clarify whether a common pathogenic mechanism links seemingly unrelated cancers.

  13. Pervasive refusal syndrome. Three German cases provide further illustration.

    PubMed

    Jans, Thomas; Ball, Juliane; Preiss, Maike; Haberhausen, Michael; Warnke, Andreas; Renner, Tobias J

    2011-09-01

    Pervasive refusal syndrome (PRS) has been proposed as a new diagnostic entity among child and adolescent psychiatric disorders. It is characterized by a cluster of life-threatening symptoms including refusal of hood intake, decreased or complete lack of mobilization, and lack of communication as well as retreat from normal life activities. Active refusal to accept help as well as neglect of personal care have been core features of PRS in the limited number of cases reported in the last decade. There have, however; been cases with predominantly passive resistance, indicating the possibility that there may be a continuum from active refusal to passive resistance within PRS. Postulating this continuum allows for the integration of "depressive devitalization" -- a refusal syndrome mainly characterized by passive resistance -- into the concept of PRS. Here, three case vignettes of adolescent patients with PRS are presented. The patients' symptomatology can be allocated on this continuum of PRS. PRS and dissociative disorders are compared in greater detail and contrasted within this discussion of differential diagnoses at the poles of such a continuum. PRS is a useful diagnosis for cases involving symptoms of predominating refusal and retreat which cannot satisfactorily be classified by existing diagnostic categories, and which can mostly clearly be separated from dissociative disorder.

  14. Anorexia nervosa and Wernicke-Korsakoff syndrome: a case report.

    PubMed

    Saad, Laura; Silva, Luiz Fal; Banzato, Claudio Em; Dantas, Clarissa R; Garcia, Celso

    2010-07-20

    Wernicke's encephalopathy is an acute, potentially fatal, neuropsychiatric syndrome resulting from thiamine deficiency. The disorder is still greatly under-diagnosed, and failure to promptly identify and adequately treat the condition can lead to death or to the chronic form of the encephalopathy - Korsakoff's syndrome. Wernicke's encephalopathy has traditionally been associated with alcoholism but, in recent years, there has been an increase in the number of clinical settings in which the disorder is observed. We report the case of a 45-year-old Caucasian woman who arrived at the emergency room presenting signs of marked malnutrition and mental confusion, ataxic gait and ophthalmoplegia. Main laboratory test findings included low serum magnesium and megaloblastic anemia. Brain magnetic resonance imaging revealed increased T2 signal in the supratentorial paraventricular region, the medial regions of the thalamus and the central and periaqueductal midbrain. The diagnosis of Wernicke's encephalopathy was made at once and immediate reposition of thiamine and magnesium was started. The patient had a long history of recurrent thoughts of being overweight, severe self-imposed diet restrictions and self-induced vomiting. She had also been drinking gin on a daily basis for the last eight years. One day after admittance the acute global confusional state resolved, but she presented severe memory deficits and confabulation. After six months of outpatient follow-up, memory deficits remained unaltered. In this case, self-imposed long-lasting nutritional deprivation is thought to be the main cause of thiamine deficiency and subsequent encephalopathy, but adjunct factors, such as magnesium depletion and chronic alcohol misuse, might have played an important role, especially in the development of Korsakoff's syndrome. The co-morbidity between eating disorders and substance abuse disorders has emerged as a significant health issue for women, and the subgroup of patients with

  15. [Cotard's syndrome: Case report and a brief review of literature].

    PubMed

    Moschopoulos, N P; Kaprinis, S; Nimatoudis, J

    2016-01-01

    The term "Cotard's syndrome" is used to describe a number of clinical features, mostly hypochondriac and nihilistic delusions, the most characteristic of which are the ideas "I am dead" and "my internal organs do not exist". Besides, anxious and depressed mood, delusions of damnation, possession and immortality, suicidal and self-mutilating behavior are included. The first description of the syndrome was made in 1880 by Cotard, who presented the case of a female patient in a lecture. He originally named it "hypochondriac delusion", and some years later "delusion of negations", while it was named "Cotard delusion" after his death. In international literature, the terms "nihilistic delusion" and "Cotard's syndrome" prevailed over "delusion of negations" and "Cotard delusion". In the present study we report the case of a 59 year-old woman, who was admitted to our department after a suicide attempt, and who showed symptoms of Cotard's syndrome for about two years, namely depressed mood, hypochondriac and nihilistic delusions, delusions of immortality and damnation, suicidal ideation, severe psychomotor retardation, diminished motivation and tendency to stay in bed. She never took the medication she was prescribed, and at times she refused to eat. During her hospitalization, there was performed a full blood panel and medical imaging, that showed chronic ischemic infarctions, periventricular leukoencephalopathy and diffuse cerebral atrophy in MRI. All the other test results were normal. She was administered treatment with haloperidol, mirtazapine and venlafaxine. Gradually, her psychomotor ability, motivation and mood improved, she didn't express suicidal ideation, her delusions were less intense and she was able to question them, but they weren't eliminated. She was discharged in improved condition, after 44 days. Cotard's syndrome isn't mentioned in the current classification systems (ICD-10, DSM-5). In literature though, it has been divided into three types, according

  16. Spontaneous Anterior Lens Capsule Rupture Of a Patient with Alport Syndrome - A Case Report.

    PubMed

    Trifonova, Kalina; Jordanoff, George; Stoyanov, Valentin; Slaveykov, Kiril

    2017-12-15

    Alport syndrome is a progressive genetic disease which is characterised by glomerulonephritis, sensorineural deafness and ocular abnormalities. We aimed to present a clinical case of a patient with Alport syndrome with spontaneous anterior lens capsule rupture. A 16-year-old male with histologically proven Alport syndrome was hospitalised in the Department of Ophthalmology, University Hospital "Prof. Stoyan Kirkovich", Stara Zagora with low vision, pain, redness, high IOP and rupture of the anterior lenticular capsule of the right eye. Phacoaspiration was successfully performed (Millenium, Bausch& Lomb, Rochester, New York, USA) with the bimanual irrigation-aspiration system (Geuder AG, Heidelberg, Germany) with excellent visual results. As the syndrome is quite rare and can lead to diagnostic difficulties for the ophthalmologist complications such as spontaneous or traumatic rupture of the capsule are not uncommon. In such cases, phacoaspiration is an efficient method for clear lens extraction after ruptures of the anterior lenticular capsule of young patients with Alport syndrome.

  17. A case study on the successful management of Cotard's syndrome in pregnancy: Case Reports.

    PubMed

    Howe, G; Srinivasan, M

    1999-01-01

    Cotard's Syndrome is rare and no cases have been reported in pregnancy. We describe a case of a woman in the third trimester who attempted suicide by jumping out of a window, sustaining multiple fractures. Delivery of her baby by Caesarean section and orthopaedic intervention was necessary before electroconvulsive therapy (ECT) could be administered, resulting in a successful outcome for both mother and child. (Int J Psych Clin Pract 1999; 3: 293-295).

  18. Congenital diaphragmatic hernia in a case of patau syndrome: a rare association.

    PubMed

    A, Jain; P, Kumar; A, Jindal; Yk, Sarin

    2015-01-01

    Congenital diaphragmatic hernia (CDH) occurs in 5-10% associated with chromosomal abnormalities like, Pallister Killian syndrome, Trisomy 18, and certain deletions.. Association of CDH with trisomy 13 (Patau syndromes) is very rare. Here, we report such an unusual association, where surgical repair was done, but eventually the case succumbed as a result of multiple fatal co-morbidities.

  19. Congenital Diaphragmatic Hernia in a Case of Patau Syndrome: A Rare Association

    PubMed Central

    A, Jain; P, Kumar; A, Jindal; Yk, Sarin

    2015-01-01

    Congenital diaphragmatic hernia (CDH) occurs in 5-10% associated with chromosomal abnormalities like, Pallister Killian syndrome, Trisomy 18, and certain deletions.. Association of CDH with trisomy 13 (Patau syndromes) is very rare. Here, we report such an unusual association, where surgical repair was done, but eventually the case succumbed as a result of multiple fatal co-morbidities. PMID:26034714

  20. Exclusion of TCOF1 mutations in a case of bilateral Goldenhar syndrome and one familial case of microtia with meatal atresia.

    PubMed

    Thiel, Christian T; Rosanowski, Frank; Kohlhase, Jürgen; Reis, André; Rauch, Anita

    2005-04-01

    A number of different disorders involving first and second branchial arch anomalies have been described as distinct entities, including Treacher-Collins-Franceschetti syndrome, Goldenhar syndrome, Nager syndrome and Miller syndrome. The significant phenotypic overlap between these disorders raises the issue of a common developmental origin. After the identification of mutations in TCOF1 as a general cause of the Treacher-Collins-Franceschetti syndrome, TCOF1 mutations were excluded in patients with unilateral signs of the Goldenhar syndrome spectrum. We also present two rare cases of bilateral Goldenhar syndrome and familial microtia with meatal atresia, respectively, in whom we also excluded TCOF1 mutations. Thus, genetic heterogeneity in different disorders of the first and second branchial arch development is supported.

  1. [Association Budd Chiari syndrome, antiphospholipid syndrome and Grave's disease].

    PubMed

    Mouelhi, Leila; Chaieb, Mouna; Debbeche, Radhouane; Salem, Mohamed; Sfar, Imene; Trabelsi, Sinda; Gorgi, Yosr; Najjar, Taoufik

    2009-02-01

    Antiphospholipid syndrome is revealed by Budd Chiari syndrome in 5% of the cases. Antiphospholipid syndrome is characterized by venous or arterial thrombosis, foetal loss and positivity of antiphospholipid antibodies, namely lupus anticoagulant, anticardiolipin antibodies and anti-beta2-glycoprotein I. Anticardiolipin antibodies was reported in auto-immune thyroid disorders, particularly in Grave's disease. Antiphospholipid syndrome associated to Grave's disease was reported in only three cases. To describe a case report of association of Grave's disease and antiphospholipid syndrome. We report the first case of Grave's disease associated with antiphospholipid syndrome, revealed by Budd Chiari syndrome. Our observation is particular by the fact that it is about a patient presenting a Grave's disease associated with antiphospholipid syndrome revealed by Budd Chiari syndrome. This triple association has never been reported in literature. Although association between antiphospholipid syndrome and Grave's disease was previously described, further studies evaluating the coexistence of these two affections in the same patient would be useful.

  2. A Case of Treacher Collins Syndrome

    PubMed Central

    Ulusal, S; Gürkan, H; Vatansever, Ü; Kürkçü, K; Tozkir, H; Acunaş, BA

    2013-01-01

    Treacher Collins syndrome (TCS) is an autosomal dominant disorder of craniofacial development with an incidence of 1/50,000 live births. Mutations of the TCOF1 gene have been found to be responsible for most cases of this mandibulofacial disorder. Here we report TCS in an individual who has a heterozygous c.1021_1022delAG deletion in exon 7 of the TCOF1 gene (NG_011341.1). This is the second Turkish patient with a severe TCS phenotype resulting from a de novo c.1021_1022delAG mutation. PMID:24778568

  3. A case of treacher collins syndrome.

    PubMed

    Ulusal, S; Gürkan, H; Vatansever, U; Kürkçü, K; Tozkir, H; Acunaş, Ba

    2013-12-01

    Treacher Collins syndrome (TCS) is an autosomal dominant disorder of craniofacial development with an incidence of 1/50,000 live births. Mutations of the TCOF1 gene have been found to be responsible for most cases of this mandibulofacial disorder. Here we report TCS in an individual who has a heterozygous c.1021_1022delAG deletion in exon 7 of the TCOF1 gene (NG_011341.1). This is the second Turkish patient with a severe TCS phenotype resulting from a de novo c.1021_1022delAG mutation.

  4. Electroconvulsive therapy-induced Wolff-Parkinson-White syndrome: a case report.

    PubMed

    Enomoto, Shingo; Yoshino, Aihide; Takase, Bonpei; Kuwahara, Tatsuro; Tatsuzawa, Yasutaka; Nomura, Soichiro

    2013-01-01

    Wolff-Parkinson-White (WPW) syndrome is characterized by premature ventricular excitation due to the presence of an abnormal accessory pathway. Electrocardiography (ECG) of patients with WPW syndrome portrays a short PR interval and a wide QRS interval with a delta wave. Herein, we report the case of a patient with schizophrenia who developed a wide QRS interval with a delta wave immediately following electroconvulsive therapy (ECT). Initially, the delta wave disappeared within 2 days after ECT. However, the duration of the delta wave increased exponentially to 4 months when ECT was repeated. Although the patient's cardiocirculatory dynamics remained normal, we continued to monitor her ECG until the delta wave disappeared because WPW syndrome can lead to serious arrhythmia. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Xeroderma pigmentosum--Cockayne syndrome complex: a further case.

    PubMed Central

    Hamel, B C; Raams, A; Schuitema-Dijkstra, A R; Simons, P; van der Burgt, I; Jaspers, N G; Kleijer, W J

    1996-01-01

    We report on a male patient born to healthy, first cousin, Moroccan parents. During the pregnancy growth retardation was observed. Birth weight, length, and OFC were all well below the 3rd centile. Facial anomalies, microphthalmia, cleft palate, small penis, and flexion contractures of large joints were noted. Cerebral MRI showed dysmyelination. The clinical course was characterised by feeding difficulties, growth failure, lack of development, photosensitivity, and death at 7 months. The main differential diagnoses were COFS syndrome and early onset Cockayne syndrome (CS). UV exposure of cultured fibroblasts showed inhibition of nucleic acids synthesis. Further DNA repair studies showed extreme cellular sensitivity to UV and xeroderma pigmentosum (XP)-like defective nucleotide excision repair (NER), which in combination with the clinical symptoms indicated the very rare XP-CS complex. Complementation analysis showed that the XPG gene is affected in this patient. In cases suspected of having COFS syndrome and early onset CS, extensive DNA repair studies are needed to reach the definitive diagnosis, thereby allowing reliable genetic counselling and prenatal diagnosis. Images PMID:8818951

  6. A case of Werner's syndrome associated with osteosarcoma.

    PubMed

    Murata, K; Hatamochi, A; Shinkai, H; Ishikawa, Y; Kawaguchi, N; Goto, M

    1999-10-01

    We described a case of Werner's syndrome associated with osteosarcoma. A 37-year-old Japanese man was diagnosed as having Werner's syndrome by the presence of juvenile cataracts, skin sclerosis and hyperpigmentation of the feet, high-pitched voice, characteristic bird-like appearance of the face with beak-shaped nose, thinning of the entire skin and hyperkeratoses on soles, hyperlipemia, hyperuricemia, diabetes melitus, and the mutated responsible gene (WRN). He had a 3-month history of a tumor on his left forearm. Histologically, the tumor included four histological patterns; a malignant fibrous histiocytoma-like, a desmoid-like, a dermatofibrosarcoma protuberans-like, and a chondrosarcoma-like pattern. Tumoral osteoid formation was also found in the tumor. Therefore, the tumor was diagnosed as osteosarcoma.

  7. Clinical features and imaging findings in a case of Capgras syndrome.

    PubMed

    Luca, Maria; Bordone, Andrea; Luca, Antonina; Patti, Andrea; Sortino, Giuseppe; Calandra, Carmela

    2013-01-01

    Capgras syndrome consists of the delusional belief that a person or persons have been replaced by doubles or impostors. It can occur in the context of both psychiatric and organic illness, and seems to be related to lesions of the bifrontal and right limbic and temporal regions. Indeed, magnetic resonance imaging has revealed brain lesions in patients suffering from Capgras syndrome. This case study reports the findings of a thorough diagnostic evaluation in a woman suffering from Capgras syndrome and presenting with the following clinical peculiarities: obsessive modality of presentation of the delusional ideation, intrusiveness of such ideation (that even disturbed her sleep), as well as a sense of alienation and utter disgust towards the double. These characteristics bring to mind the typical aspects of obsessive-compulsive disorder. Neuroanatomic investigation, through magnetic resonance imaging, performed on this patient showed alteration of the bilateral semioval centers, which are brain regions associated with the emotion of disgust and often show alterations in subjects suffering from obsessive-compulsive disorder. Hence, neuroimaging allows researchers to put forward the hypothesis of a common neuroanatomic basis for Capgras syndrome and obsessive-compulsive disorder, at least for cases in which the delusional ideation is associated with deep feelings of disgust and presents with a certain pervasiveness.

  8. Clinical features and imaging findings in a case of Capgras syndrome

    PubMed Central

    Luca, Maria; Bordone, Andrea; Luca, Antonina; Patti, Andrea; Sortino, Giuseppe; Calandra, Carmela

    2013-01-01

    Capgras syndrome consists of the delusional belief that a person or persons have been replaced by doubles or impostors. It can occur in the context of both psychiatric and organic illness, and seems to be related to lesions of the bifrontal and right limbic and temporal regions. Indeed, magnetic resonance imaging has revealed brain lesions in patients suffering from Capgras syndrome. This case study reports the findings of a thorough diagnostic evaluation in a woman suffering from Capgras syndrome and presenting with the following clinical peculiarities: obsessive modality of presentation of the delusional ideation, intrusiveness of such ideation (that even disturbed her sleep), as well as a sense of alienation and utter disgust towards the double. These characteristics bring to mind the typical aspects of obsessive-compulsive disorder. Neuroanatomic investigation, through magnetic resonance imaging, performed on this patient showed alteration of the bilateral semioval centers, which are brain regions associated with the emotion of disgust and often show alterations in subjects suffering from obsessive-compulsive disorder. Hence, neuroimaging allows researchers to put forward the hypothesis of a common neuroanatomic basis for Capgras syndrome and obsessive-compulsive disorder, at least for cases in which the delusional ideation is associated with deep feelings of disgust and presents with a certain pervasiveness. PMID:23950650

  9. Next Generation Sequencing Approach in a Prenatal Case of Cardio-Facio-Cutaneus Syndrome.

    PubMed

    Mucciolo, Mafalda; Dello Russo, Claudio; D'Emidio, Laura; Mesoraca, Alvaro; Giorlandino, Claudio

    2016-06-16

    Cardiofaciocutaneous syndrome (CFCS) belongs to a group of developmental disorders due to defects in the Ras/Mitogen-Activated Protein Kinase (RAS/MAPK) signaling pathway named RASophaties. While postnatal presentation of these disorders is well known, the prenatal and neonatal characteristics are less recognized. Noonan syndrome, Costello syndrome, and CFCS diagnosis should be considered in pregnancies with a normal karyotype and in the case of ultrasound findings such as increased nuchal translucency, polyhydramnios, macrosomia and cardiac defect. Because all the RASopathies share similar clinical features, their molecular characterization is complex, time consuming and expensive. Here we report a case of CFCS prenatally diagnosed through Next Generation Prenatal Diagnosis (NGPD), a new targeted approach that allows us to concurrently investigate all the genes involved in the RASophaties.

  10. Next Generation Sequencing Approach in a Prenatal Case of Cardio-Facio-Cutaneus Syndrome

    PubMed Central

    Mucciolo, Mafalda; Dello Russo, Claudio; D’Emidio, Laura; Mesoraca, Alvaro; Giorlandino, Claudio

    2016-01-01

    Cardiofaciocutaneous syndrome (CFCS) belongs to a group of developmental disorders due to defects in the Ras/Mitogen-Activated Protein Kinase (RAS/MAPK) signaling pathway named RASophaties. While postnatal presentation of these disorders is well known, the prenatal and neonatal characteristics are less recognized. Noonan syndrome, Costello syndrome, and CFCS diagnosis should be considered in pregnancies with a normal karyotype and in the case of ultrasound findings such as increased nuchal translucency, polyhydramnios, macrosomia and cardiac defect. Because all the RASopathies share similar clinical features, their molecular characterization is complex, time consuming and expensive. Here we report a case of CFCS prenatally diagnosed through Next Generation Prenatal Diagnosis (NGPD), a new targeted approach that allows us to concurrently investigate all the genes involved in the RASophaties. PMID:27322245

  11. Early orthodontic management of Crouzon Syndrome: a case report.

    PubMed

    Hlongwa, P

    2009-03-01

    Crouzon Syndrome is an autosomal dominant disorder with complete penetrance and variable expressivity. Described by a French neurosurgeon in 1912, it is a rare genetic disorder. Crouzon syndrome is caused by mutation in the fibroblast growth factor receptor 2 (FGFR2) gene. The disease is characterized by premature synostosis of coronal and sagittal sutures which begins in the first year of life. Once the sutures become closed, growth potential to those sutures is restricted. However, multiple sutural synostoses frequently extend to premature fusion of skull base causing midfacial hypoplasia, shallow orbit, maxillary hypoplasia and occasional upper airway obstruction.The case of a 7-year-old South African black boy with Crouzon Syndrome is presented. He presented with characteristic triad of cranial deformity, maxillary hypoplasia and exophthalmos. The clinical, cephalometric features and initial orthodontic management of this patient are discussed as part of multidisciplinary management.

  12. [Early diagnosis and treatment of compartment syndrome caused by landslides:a report of 20 cases].

    PubMed

    Xie, Hong-Bo; Peng, Zi-Lai; Liu, Xu-Bang; Chen, Lian

    2012-01-01

    To summarize early diagnosis and treatment methods of 20 patients with compartment syndrome caused by landslides during coal mine accidents in order to improve the level of diagnosis and treatment of compartment syndrome and reduce disability. From September 2006 to April 2010,20 patients with compartment syndrome were treated with the methods of early decompression, systemic support. All the patients were male with an average age of 42 years (ranged, 23 to 54). All the patients with high tension limb swelling, pain, referred pain passive positive; 5 extremities feeling diminish or disappear and the distal blood vessel beat were normal or weakened or disappeared; myoglobinuria, hyperkalemia, serum urea nitrogen and creatinine increased in 5 cases and oliguria in occurred 1 case. The function of affected limbs was observed according to disability ratings. Three cases complicated with infection of affected limb and 6 cases occurred with renal function insufficiency. Total recovery was in 16 cases, basically recovery in 3, amputation in 1 case. All patients were followed up for 6-15 months with an average of 12 months. The ability to work according to national standard identification--Employee work-related injuries and occupational disability rating classification (GB/T16180-2006) to assess, grade 5 was in 1 case, grade 8 in 2 cases, grade 10 in 1 case, no grade in 16 cases. Arteriopalmus of dorsalis pedis weaken and vanished can not be regard as an evidence in early diagnosis of compartment syndrome. Early diagnosis and decompression, systemic support and treatment is the key in reducing disability.

  13. Follow-up of hearing thresholds among forge hammering workers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kamal, A.A.; Mikael, R.A.; Faris, R.

    Hearing threshold was reexamined in a group of forge hammering workers investigated 8 years ago with consideration of the age effect and of auditory symptoms. Workers were exposed to impact noise that ranged from 112 to 139 dB(A)--at an irregular rate of 20 to 50 drop/minute--and a continuous background noise that ranged from 90 to 94 dB(A). Similar to what was observed 8 years ago, the present permanent threshold shift (PTS) showed a maximum notch at the frequency of 6 kHz and considerable elevations at the frequencies of 0.25-1 kHz. The age-corrected PTS and the postexposure hearing threshold were significantlymore » higher than the corresponding previous values at the frequencies 0.25, 0.5, 1, and 8 kHz only. The rise was more evident at the low than at the high frequencies. Temporary threshold shift (TTS) values were significantly less than those 8 years ago. Contrary to the previous TTS, the present TTS were higher at low than at high frequencies. Although progression of PTS at the frequencies 0.25 and 0.5 kHz was continuous throughout the observed durations of exposure, progression at higher frequencies occurred essentially in the first 10 to 15 years of exposure. Thereafter, it followed a much slower rate. Tinnitus was significantly associated with difficulty in hearing the human voice and with elevation of PTS at all the tested frequencies, while acoustic after-image was significantly associated with increment of PTS at the frequencies 0.25-2 kHz. No relation between PTS and smoking was found. PTS at low frequencies may provide an indication of progression of hearing damage when the sensitivity at 6 and 4 kHz diminishes after prolonged years of exposure. Tinnitus and acoustic after-image are related to the auditory effect of forge hammering noise.« less

  14. Conn syndrome and Crohn disease in a pediatric case: an interesting parallel.

    PubMed

    Rodriguez, Manuel A; Alkhoury, Fuad; Malvezzi, Leopoldo; Diaz, Alejandro

    2013-01-01

    Conn syndrome is characterized by surreptitious secretion of aldosterone in which patients are found to have hypertension, hypokalemia, and metabolic alkalosis. Although rare, the most common presentation in the pediatric population is bilateral hyperplasia of the adrenal glands as opposed to an adenoma. Crohn disease is part of the spectrum of inflammatory bowel disease, which manifests in children as flare-ups of bloody diarrhea and abdominal pain. The association of concurrent Conn syndrome and Crohn disease has been previously presented in two cases in adults. This is the first pediatric case to be reported in the literature.

  15. [A case of Munchausen syndrome by proxy].

    PubMed

    Feenstra, J; Merth, I T; Treffers, P D

    1988-08-01

    In this paper the case is described of a one-year-old girl who was diagnosed as to have the Münchhausen syndrome by proxy. There had been a single-sided, chronic parotitis, followed by a single-sided orbita-cellulitis. In the pathological-anatomical matter derived from the parotid a substance was found that does not belong to the human body (most likely to be alum), and which contained aluminium, silica, and iron. Based on pediatric, psychological, and child psychiatric diagnoses, the conclusion was that in all probability the matter was injected by the patient's grandmother, who acted as foster-mother. The grand-mother herself appeared to be a patient with the Münchhausen syndrome. After the girl was separated from her grand-parents, she soon recovered. Following after a total stay of 18 months in three different hospitals, the girl could be placed in a therapeutic foster home.

  16. Drug-induced pseudo-Sezary syndrome: a case report and literature review.

    PubMed

    Reeder, Margo J; Wood, Gary S

    2015-01-01

    Pseudo-Sezary syndrome is a benign lymphoproliferative disorder, which clinically and pathologically mimics true Sezary syndrome. In this article, a case of pseudo-Sezary syndrome and review the literature has been reported. The patient was a 51-year-old man who developed erythroderma and palmoplantar keratoderma. The patient's medication history included fosinopril and combination metoprolol/hydrochlorothiazide. Flow cytometry showed a population of 2500 "Sezary-like" CD4726 T cells per microliter in the peripheral blood. Skin biopsy showed numerous atypical lymphocytes with epidermotropism, and there was matching dominant T-cell clonality in the skin and peripheral blood. After stopping all antihypertensive medications, the eruption resolved in its entirety.

  17. The stomatopod dactyl club: a formidable damage-tolerant biological hammer.

    PubMed

    Weaver, James C; Milliron, Garrett W; Miserez, Ali; Evans-Lutterodt, Kenneth; Herrera, Steven; Gallana, Isaias; Mershon, William J; Swanson, Brook; Zavattieri, Pablo; DiMasi, Elaine; Kisailus, David

    2012-06-08

    Nature has evolved efficient strategies to synthesize complex mineralized structures that exhibit exceptional damage tolerance. One such example is found in the hypermineralized hammer-like dactyl clubs of the stomatopods, a group of highly aggressive marine crustaceans. The dactyl clubs from one species, Odontodactylus scyllarus, exhibit an impressive set of characteristics adapted for surviving high-velocity impacts on the heavily mineralized prey on which they feed. Consisting of a multiphase composite of oriented crystalline hydroxyapatite and amorphous calcium phosphate and carbonate, in conjunction with a highly expanded helicoidal organization of the fibrillar chitinous organic matrix, these structures display several effective lines of defense against catastrophic failure during repetitive high-energy loading events.

  18. The Stomatopod Dactyl Club: A Formidable Damage-Tolerant Biological Hammer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Weaver J. C.; DiMasi E.; Milliron, G.W.

    2012-06-08

    Nature has evolved efficient strategies to synthesize complex mineralized structures that exhibit exceptional damage tolerance. One such example is found in the hypermineralized hammer-like dactyl clubs of the stomatopods, a group of highly aggressive marine crustaceans. The dactyl clubs from one species, Odontodactylus scyllarus, exhibit an impressive set of characteristics adapted for surviving high-velocity impacts on the heavily mineralized prey on which they feed. Consisting of a multiphase composite of oriented crystalline hydroxyapatite and amorphous calcium phosphate and carbonate, in conjunction with a highly expanded helicoidal organization of the fibrillar chitinous organic matrix, these structures display several effective lines ofmore » defense against catastrophic failure during repetitive high-energy loading events.« less

  19. A "reverse" Maffucci's syndrome: case report and short review of the literature.

    PubMed

    Matzaroglou, Charalampos; Megas, Panagiotis; Panagiotopoulos, Elias; Notopoulos, Athanasios; Saridis, Alkis; Sourgiadaki, Efrosini; Koumoundourou, Dimitra; Dimakopoulos, Panagiotis

    2005-01-01

    Maffucci's syndrome is a congenital, non-hereditary mesodermal dysplasia associated with multiple enchondromas and after some years accompanied by hemangiomas. We describe a rare case of "reverse" Maffucci's syndrome in a 42-year-old woman who has suffered from multiple hemangiomas for the last 24 years. The last two years she complained for heel pain. Bone scintigraphic examination showed abnormal findings in the left calcaneal bone. The scintigraphy, radiology and histology findings revealed multiple enchondromas, so the diagnosis was changed into Maffucci's syndrome. After one year, the left calcaneal bone showed sarcomatous transformation.

  20. Unusual association of non-anaplastic Wilms tumor and Cornelia de Lange syndrome: case report.

    PubMed

    Santoro, Claudia; Apicella, Andrea; Casale, Fiorina; La Manna, Angela; Di Martino, Martina; Di Pinto, Daniela; Indolfi, Cristiana; Perrotta, Silverio

    2016-06-13

    Cornelia de Lange syndrome is the prototype for cohesinopathy disorders, which are characterized by defects in chromosome segregation. Kidney malformations, including nephrogenic rests, are common in Cornelia de Lange syndrome. Only one post-mortem case report has described an association between Wilms tumor and Cornelia de Lange syndrome. Here, we describe the first case of a living child with both diseases. Non-anaplastic triphasic nephroblastoma was diagnosed in a patient carrying a not yet reported mutation in NIPBL (c.4920 G > A). The patient had the typical facial appearance and intellectual disability associated with Cornelia de Lange syndrome in absence of limb involvement. The child's kidneys were examined by ultrasound at 2 years of age to exclude kidney abnormalities associated with the syndrome. She underwent pre-operative chemotherapy and nephrectomy. Seven months later she was healthy and without residual detectable disease. The previous report of such co-occurrence, together with our report and previous reports of nephrogenic rests, led us to wonder if there may be any causal relationship between these two rare entities. The wingless/integrated (Wnt) pathway, which is implicated in kidney development, is constitutively activated in approximately 15-20 % of all non-anaplastic Wilms tumors. Interestingly, the Wnt pathway was recently found to be perturbed in a zebrafish model of Cornelia de Lange syndrome. Mutations in cohesin complex genes and regulators have also been identified in several types of cancers. On the other hand, there is no clear evidence of an increased risk of cancer in Cornelia de Lange syndrome, and no other similar cases have been published since the fist one reported by Cohen, and this prompts to think Wilms tumor and Cornelia de Lange syndrome occurred together in our patient by chance.

  1. A patient with Melorheostosis manifesting with features similar to tricho-dento-osseous syndrome: a case report

    PubMed Central

    Al Kaissi, Ali; Skoumal, Martin; Roetzer, Katharina; Grill, Franz; Klaushofer, Klaus

    2008-01-01

    Introduction A case of melorheostosis in association with tricho-dento-osseous (TDO) syndrome has been encountered. Case presentation The clinical and the radiographic manifestations of melorheostosis have been encountered in a 41-year-old man. Mutations in the 13 exons and flanking intronic regions of the LEMD3-gene have not been detected. His phenotypic features were consistent but not completely diagnostic for tricho-dento-osseous syndrome (TDO). We report what might be a novel syndromic association. Conclusion Melorheostosis has not previously been reported to be a part of TDO and an extensive review of the literature suggests that the constellation of hair, tooth and bone abnormalities found in our patient either represents an unusual variant of tricho-dento-osseous syndrome or a new syndrome. PMID:18284671

  2. Dental and craniofacial characteristics in a patient with Dubowitz syndrome: a case report.

    PubMed

    Ballini, Andrea; Cantore, Stefania; Tullo, Domenica; Desiate, Apollonia

    2011-01-27

    Dubowitz syndrome is a very rare, autosomal recessive disease characterized by microcephaly, growth retardation, a high sloping forehead, facial asymmetry, blepharophimosis, sparse hair and eyebrows, low-set ears and mental retardation. Symptoms vary between patients, but other characteristics include a soft high-pitched voice, dental and craniofacial abnormalities, partial webbing of the fingers and toes, palate deformations, genital abnormalities, eczema, hyperactivity, preference for concrete over abstract thinking, language difficulties and an aversion to crowds. We describe the craniofacial and dental characteristics of a 12-year-old Caucasian Italian boy with both the typical and less common findings of Dubowitz syndrome. Diagnosis of Dubowitz syndrome is mainly based on the facial phenotype. Possible conditions for differential diagnosis include Bloom syndrome, Smith-Lemli-Opitz syndrome, and fetal alcohol syndrome. As there are few reports of this syndrome in the literature, we hope this case report will enable health professionals to recognize the phenotypic alterations of this syndrome, and allow early referral for the necessary multidisciplinary treatments.

  3. Neonatal Lemierre Syndrome: Youngest Reported Case and Literature Review.

    PubMed

    Raggio, Blake S; Grant, Maria C; Rodriguez, Kimsey; Cripe, Patrick J

    2018-03-01

    A previously healthy 5-week-old female was admitted for sepsis secondary to methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. After several days of hospitalization, she experienced acute decompensation in mental status despite having received targeted antibiotic therapy. Imaging revealed left peritonsillar/parapharyngeal space abscess, left venous thrombophlebitis of the internal jugular vein, and septic emboli of the lungs and brain consistent with Lemierre syndrome. Bedside needle aspiration of the parapharyngeal abscess confirmed MRSA involvement. Unfortunately, the patient continued to deteriorate over the next several days and life support was withdrawn on hospital day 16. We present the youngest reported case of Lemierre syndrome and review the literature.

  4. Parinaud syndrome: a 25-year (1991-2016) review of 40 consecutive adult cases.

    PubMed

    Shields, Melissa; Sinkar, Swati; Chan, WengOnn; Crompton, John

    2017-12-01

    To characterize the clinical features, aetiology and management of ophthalmic symptoms in adult patients with Parinaud syndrome. This is a retrospective, non-comparative observational case series. We reviewed 40 consecutive charts of adult patients with the clinical diagnosis of Parinaud syndrome at the Royal Adelaide Hospital Department of Ophthalmology in Adelaide, South Australia, between 1991 and 2016. Charts were reviewed for the following: (1) demographic information, (2) clinical presentation, (3) neuro-ophthalmology signs, (4) aetiology of Parinaud syndrome, and (5) management. Examination findings were collected at initial evaluation, throughout the course of follow-up, and at last follow-up. All the cases were assessed by one of the authors (JLC). The commonest presenting symptoms were diplopia (67.5%) and blurred vision (25%) followed by visual field defect (12.5%), ataxia (7.5%) and manifest squint (7.5%). The commonest presenting signs were vertical gaze palsy (100%), convergence-retraction nystagmus (87.5%) and light-near dissociation (65.0%). Only 65.0% patients had the classical triad of vertical gaze palsy, convergence-retraction nystagmus and light-near dissociation. Midbrain pathologies including haemorrhage (30.0%), infarction (20.0%) and tumour (15.0%) were the commonest aetiology. Pineal region tumours accounted for 30.0% of presentations. Symptoms were managed conservatively in 45% of cases with temporary occlusion, prisms or refractive correction, and observation in 42.5% of cases. Surgical intervention for refractory diplopia was required in 12.5% of cases, of which 80% reported symptom resolution following surgery. Our series highlights the variable clinical presentation of Parinaud syndrome. The classic triad of conjugate upgaze paralysis, convergence-retraction nystagmus and light-near dissociation was only present in 65% of cases. Pineal neoplasms remain an important aetiological consideration; however, primary midbrain pathology

  5. Wernicke-Korsakoff Syndrome as a Consequence of Delusional Food Refusal: A Case Study.

    PubMed

    Hargrave, David D; Schroeder, Ryan W; Heinrichs, Robin J; Baade, Lyle E

    2015-12-01

    Wernicke-Korsakoff syndrome is caused by thiamine (vitamin B1) deficiency, typically resulting from malnutrition secondary to chronic alcohol abuse. Less often, other conditions can lead to malnutrition and Wernicke-Korsakoff syndrome. We describe a 35-year-old man who developed Wernicke-Korsakoff syndrome with a typical neurologic and neuropsychological presentation after somatic delusions led him to refuse to eat. Cases like his serve to heighten awareness of the interplay between psychiatric and neurologic conditions, their sometimes atypical pathogenesis, and the value to primary care providers of consulting with psychiatrists, neurologists, and neuropsychologists when managing patients with possible Wernicke-Korsakoff syndrome.

  6. Blue Vision (Cyanopsia) Associated With TURP Syndrome: A Case Report.

    PubMed

    Fox, William C; Moon, Richard E

    2018-05-29

    There have been many complications associated with transurethral resection of the prostate (TURP), known as TURP syndrome. Of the various irrigation fluids used for TURP, glycine irrigant has been historically popular given its relatively low cost. It is also a nonconductive solution and only slightly hypoosmolar, reducing the risk of burn injury or significant hemolysis. However, there have been many case reports of central nervous system toxicity such as transient blindness and encephalopathy related to glycine toxicity. Here, we report blue vision (cyanopsia), which has never been reported as a symptom of TURP syndrome.

  7. A Case of Fisher-Bickerstaff Syndrome Overlapped by Guillain-Barré Syndrome

    PubMed Central

    Fujii, Daiki; Manabe, Yasuhiro; Takahasi, Yosiaki; Narai, Hisashi; Omori, Nobuhiko; Kusunoki, Susumu; Abe, Koji

    2012-01-01

    We report a 72-year-old woman with overlapping Miller Fisher syndrome (MFS), Guillain-Barré syndrome (GBS) and Bickerstaff's brainstem encephalitis (BBE). She developed diplopia and unsteady gait a week after an upper respiratory infection on day 1. She had weakness of both upper limbs on day 3 and became drowsy, and her respiratory status worsened on day 5. Neurologic examination revealed ophthalmoplegia, ataxia, symmetrical weakness, areflexia, and consciousness disturbance. We diagnosed her with MFS on day 1, GBS on day 3 and overlapping BBE on day 5. She underwent immunoadsorption therapy and two courses of intravenous immunoglobulin therapy. Ten months after onset, her symptoms had fully recovered. Anti-GM1 IgG, GD1a IgG, GQ1b IgG, and GT1a IgG antibodies were positive. Our case supports the notion that MFS, GBS, and BBE are all part of a continuous clinical spectrum, which is an antibody-mediated process. PMID:23275783

  8. Mental health diagnoses in patients with interstitial cystitis/painful bladder syndrome and chronic prostatitis/chronic pelvic pain syndrome: a case/control study.

    PubMed

    Clemens, J Quentin; Brown, Sheila O; Calhoun, Elizabeth A

    2008-10-01

    We compared the rate of mental health disorders in male and female patients with pelvic pain and control subjects. Male patients with chronic prostatitis/chronic pelvic pain syndrome (174) and female patients with interstitial cystitis/painful bladder syndrome (111) were identified from a urology tertiary care clinic population. A control group consisting of 72 men and 175 women was also recruited. Subjects completed self-administered questionnaires that included items about demographics, medical history, medication use and urological symptoms. The Patient Health Questionnaire was used to identify depression and panic disorder. Multiple logistic regression was used to determine odds ratios for the presence of a mental health diagnosis. Mental health disorders were identified in 13% of the chronic prostatitis/chronic pelvic pain syndrome cases and 4% of male controls (OR 2.0, p = 0.04), as well as in 23% of interstitial cystitis/painful bladder syndrome cases and 3% of female controls (OR 8.2, p <0.0001). Disease status (case vs control) (OR 10.4, p = 0.001) and income greater than $50,000 (OR 0.34, p = 0.008) were the only 2 variables independently predictive of the presence of a mental health diagnosis. Age, gender, race/ethnicity and education were not predictive. Medications for anxiety, depression or stress were being taken by 18% of patients with chronic prostatitis/chronic pelvic pain syndrome, 37% of those with interstitial cystitis/painful bladder syndrome, 7% of male controls and 13% of female controls. Depression and panic disorder are significantly more common in men and women with pelvic pain conditions than in controls. Medication use data suggest that anxiety and depression may be more difficult to treat in patients with urological pain syndromes than in controls.

  9. Ritscher-Schinzel cranio-cerebello-cardiac (3C) syndrome: report of four new cases and review.

    PubMed

    Leonardi, M L; Pai, G S; Wilkes, B; Lebel, R R

    2001-08-15

    Ritscher-Schinzel syndrome, also known as the 3C syndrome, is a rare, autosomal recessive syndrome characterized by craniofacial, cerebellar, and cardiac anomalies. Cardiac manifestations include ventricular septal defect, atrial septal defect, tetralogy of Fallot, double outlet right ventricle, hypoplastic left heart, aortic stenosis, pulmonic stenosis and other valvular anomalies. Central nervous system anomalies include Dandy-Walker malformation, cerebellar vermis hypoplasia and enlargement of the cisterna magna. Craniofacial abnormalities seen are cleft palate, ocular coloboma, prominent occiput, low-set ears, hypertelorism, down-slanting palpebral fissures, depressed nasal bridge and micrognathia. Dandy-Walker malformation, posterior fossa cyst, hydrocephalus and congenital heart defect are common malformations that may occur in isolation or as a part of many syndromes. Accurate genetic diagnosis and counseling require detailed analysis of the external as well as the internal anatomy and knowledge of the relative frequencies of various malformations in syndromes that may have overlapping clinical signs. We have had the opportunity recently to study four cases of the Ritscher-Schinzel syndrome. A review of all reported cases is presented and an attempt made to define the minimum diagnostic criteria for the Ritscher-Schinzel syndrome. Of the nine craniofacial anomalies commonly reported as a part of the Ritscher-Schinzel syndrome, we consider two i.e., cleft palate and ocular coloboma, to be readily and objectively ascertainable. The other seven craniofacial traits, however, are somewhat subjective, require expert interpretation and are sometimes difficult to ascertain in a newborn or stillborn fetus. These are prominent forehead, prominent occiput, hypertelorism, down-slanting palpebral fissures, low-set ears, depressed nasal bridge and micrognathia. At least four of these were present in all cases that had a secure diagnosis of the Ritscher-Schinzel syndrome

  10. Alagille Syndrome: A Case Report Highlighting Dysmorphic Facies, Chronic Illness, and Depression

    PubMed Central

    Winthrop, Zachary A.; Salman, Rabia; Majeed, Salman

    2016-01-01

    Alagille syndrome is a rare multisystem disorder affecting the liver, heart, vertebrae, eyes, and face. Alagille syndrome shares multiple phenotypic variants of other congenital or chronic childhood illnesses such as DiGeorge syndrome, Down syndrome, spina bifida, type 1 diabetes mellitus, and cystic fibrosis. All of these chronic illnesses have well-established links to psychiatric conditions. There are few community resources for Alagille patients, as it is an extremely rare condition. Despite the overlap with other chronic childhood illnesses, the psychiatric manifestations of Alagille syndrome have not been previously discussed in literature. The current study is a case report of a twelve-year-old female hospitalized in our pediatric psychiatric hospital for suicidal ideation with intent and plan. The patient had major depressive disorder, anxiety, other specified feeding and eating disorder, and attention-deficit/hyperactive disorder. PMID:28018696

  11. Nutrition in clinical practice-the refeeding syndrome: illustrative cases and guidelines for prevention and treatment.

    PubMed

    Stanga, Z; Brunner, A; Leuenberger, M; Grimble, R F; Shenkin, A; Allison, S P; Lobo, D N

    2008-06-01

    The refeeding syndrome is a potentially lethal complication of refeeding in patients who are severely malnourished from whatever cause. Too rapid refeeding, particularly with carbohydrate may precipitate a number of metabolic and pathophysiological complications, which may adversely affect the cardiac, respiratory, haematological, hepatic and neuromuscular systems leading to clinical complications and even death. We aimed to review the development of the refeeding syndrome in a variety of situations and, from this and the literature, devise guidelines to prevent and treat the condition. We report seven cases illustrating different aspects of the refeeding syndrome and the measures used to treat it. The specific complications encountered, their physiological mechanisms, identification of patients at risk, and prevention and treatment are discussed. Each case developed one or more of the features of the refeeding syndrome including deficiencies and low plasma levels of potassium, phosphate, magnesium and thiamine combined with salt and water retention. These responded to specific interventions. In most cases, these abnormalities could have been anticipated and prevented. The main features of the refeeding syndrome are described with a protocol to anticipate, prevent and treat the condition in adults.

  12. Stable sonoluminescence within a water hammer tube.

    PubMed

    Chakravarty, Avik; Georghiou, Theo; Phillipson, Tacye E; Walton, Alan J

    2004-06-01

    The sonoluminescence (SL) from the collapse of a single gas bubble within a liquid can be produced repetitively using an acoustic resonator. An alternative technique using a water hammer tube, producing SL from bubbles of greater size, is described here. A sealed vertical tube partly filled with a liquid and a gas at low pressure is subjected to vertical vibrations. The oscillation of the pressure within the liquid column, due to inertial forces, excites cavitation bubbles to grow and collapse. Rotation is used to confine the bubbles to the axis of the tube. Bright SL emissions were observed in a number of liquids. Repetitive emission was produced from bubbles in condensed phosphoric acid. Bubbles of 0.4 mm ambient radius (containing 2x 10(14) xenon atoms) were excited by vibration at 35 Hz. Approximately 10(12) photons were emitted per collapse in the range 400-700 nm (over four orders of magnitude greater than the brightest SL reported previously), corresponding to a 1% efficiency of the conversion of mechanical energy into light.

  13. [A case of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episode/Leigh overlap syndrome].

    PubMed

    Matsui, Jun; Takano, Tomoyuki; Ryujin, Fukiko; Anzai, Yuko; Yoshioka, Seiichiro; Takeuchi, Yoshihiro; Goto, Yuichi

    2014-09-01

    We experienced a case in which mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) was identified as complications following the onset of Leigh syndrome along with a 10191 T>C mutation of the mitochondrial gene. The case pertains to a 26-year-old woman. The disease appeared when she was 11 years old due to divergent strabismus, at which point a diagnosis of juvenile Leigh syndrome was made. Many infraction images not conforming to the vessel region were observed upon a brain MRI which was performed at 26 years of age, thus leading to her being diagnosed with MELAS as a complication. Upoon bibliographical consideration, it was speculated that the clinical features of MELAS/Leigh overlap syndrome clearly differ from Leigh syndrome in terms of age of onset, symptoms, and prognosis. Pleiotropic genetic factors including heteroplasmy were presumed to be involved in the diverse phenotype of overlap syndrome.

  14. Kounis syndrome: a stinging case of ST-elevation myocardial infarction.

    PubMed

    Scherbak, Dmitriy; Lazkani, Mohamad; Sparacino, Nick; Loli, Akil

    2015-04-01

    Kounis syndrome is not a rare but an infrequently diagnosed non-thrombogenic cause of angina or myocardial infarction triggered by the release of inflammatory mediators following an allergic or anaphylactic reaction. This so-called "allergic angina" is seen in the setting of anaphylactic reactions and is believed to be due to mast cell release causing coronary vasospasm. The treatment of such cases is often with epinephrine, which has also been described in the literature as another rare cause of coronary vasospasm. We present a case of Kounis syndrome seen in a 46 year-old male who suffered two bee stings while landscaping in his yard. He developed an anaphylactic reaction and was promptly treated with IM epinephrine injection by paramedics at arrival and developed marked ST elevations on EKG in the inferior leads with reciprocal ST depressions in the anterior leads. His troponin peaked at 13 ng/mL and tryptase level was 15 ng/mL (normal <10 ng/mL). Coronary catheterisation showed non-diseased coronary arteries and a normal ejection fraction without evidence of vasospasm. He was afterwards treated with an epinephrine drip for distributive shock. Interestingly this syndrome was not provoked when re-challenged with this therapy, suggestive of an allergic reaction rather than epinephrine as the aetiology of his presumed vasospasm. This patient's ST segment elevation and troponin elevation was due to Kounis syndrome. Awareness that anaphylactic reactions can lead to Kounis syndrome can lead to prompt appropriate treatment for this life threatening condition. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  15. Treatment of cuboid syndrome secondary to lateral ankle sprains: a case series.

    PubMed

    Jennings, Jason; Davies, George J

    2005-07-01

    Case series. Plantar flexion/inversion ankle sprains are one of the most frequently occurring sports injuries. Cuboid syndrome, which is difficult to diagnose, may result from a plantar flexion/ inversion ankle injury and could become the source of lateral ankle/midfoot pain. The objective of this case series is to describe the examination, evaluation, and treatment of the cuboid syndrome following a lateral ankle sprain. Seven patients were seen in our clinic 1 to 8 weeks following a lateral ankle sprain with a chief complaint of lateral ankle/midfoot pain. In these 7 patients, the presence of cuboid syndrome was identified independently by 2 examiners. Treatment consisted of a cuboid manipulation. All 7 patients returned to sports activities following 1 to 2 treatments consisting of the "cuboid whip" manipulation. No recurrence of symptoms was reported upon immediate return to competition or during the remainder of the season (mean follow-up, 5.7 months; range, 2 to 8 months). Based on those 7 patients, our results suggest that patients who are properly diagnosed with cuboid syndrome and receive the cuboid manipulation can return to competitive activity within 1 or 2 visits without injury recurrence.

  16. [Lupoid syndrome in "BCG-itis." Report of a case].

    PubMed

    Ramírez, O; Ramírez, R

    1986-01-01

    It is presented the first case of lupoid syndrome of "BCG-itis" found in El Salvador. Its clinic-pathological study is conclusive for such dermatological entity. The complications of vaccination with BCG are rare. It must be treated as an active tuberculosis, but with a greater control of the patient.

  17. Guillain-Barré Syndrome in a Boy With Lung Fluke Infection: Case Report and Literature Review.

    PubMed

    Yang, Cui-Wei; Gao, Feng; Xia, Zhe-Zhi

    2015-08-01

    Guillain-Barré syndrome is the most common acute peripheral neuropathy in children in most countries. The cause and pathogenesis of the disease have yet to be clarified. There have been only a few reports of Guillain-Barré syndrome resulting from parasite infections worldwide, no cases of Guillain-Barré syndrome after lung fluke infection have been reported. We report a case of an 8-year-old male patient with Guillain-Barré syndrome after lung fluke infection. The child had a history of consumption of undercooked crabs. He was diagnosed with paragonimiasis. The patient experienced paralysis of and pain in the lower limbs about 3 weeks after symptom onset. Neurologic and electrophysiologic examination findings supported the diagnosis of Guillain-Barré syndrome. Parasitic infections should also be considered when determining which antecedent infection is associated with Guillain-Barré syndrome. © The Author(s) 2014.

  18. Cannabis smoking and acute coronary syndrome: two illustrative cases.

    PubMed

    Dwivedi, Shridhar; Kumar, Vivek; Aggarwal, Amitesh

    2008-08-18

    Cannabis is a common substance of drug abuse among the young adults because of its euphoric and addictive effects. The pathophysiological effects of cannabis smoking and its relation to adverse cardiovascular events are well known. However, the relative contribution of cannabis smoking when combined with tobacco smoking to coronary artery disease is unclear and has not been well emphasized. We describe two cases of acute coronary syndrome occurring in cannabis smokers who were tobacco smoker too. One, a 23 year old young boy who suffered from hypertension and acute coronary syndrome at a very young age and other, a 50 year old male admitted with acute coronary syndrome, developed asymptomatic dynamic electrocardiographic changes and had beta-blocker induced severe bronchospasm. The modifiable nature of cannabis smoking and cigarette smoking, which often go hand in hand, needs no over emphasis. The cessation of twin smoking habits along with correction of other coronary artery disease risk factors is an important part of primary and secondary prevention.

  19. Refeeding syndrome in a vegan patient with stage IV gastric cancer: a novel case.

    PubMed

    Brown, Teresa V; Moss, Rebecca A

    2015-03-01

    The refeeding syndrome encompasses the complex physiologic state that occurs in malnourished patients who receive nutrition after a period of decreased oral intake. The hallmark of the syndrome is hypophosphatemia, though other electrolyte imbalances and severe fluid shifts are commonly involved. Patients with newly diagnosed malignancies and those undergoing treatment for malignancies are at increased risk for developing the refeeding syndrome, however there are few reported cases or other data in the oncology literature regarding this syndrome in cancer patients. ©2015 Frontline Medical Communications.

  20. Laugier–Hunziker syndrome: a report of three cases and literature review

    PubMed Central

    Wang, Wen-Mei; Wang, Xiang; Duan, Ning; Jiang, Hong-Liu; Huang, Xiao-Feng

    2012-01-01

    Laugier–Hunziker syndrome (LHS) is an acquired pigmentary condition affecting lips, oral mucosa and acral area, frequently associated with longitudinal melanonychia. There is neither malignant predisposition nor underlying systemic abnormality associated with LHS. Herein, we present three uncommon cases of LHS with possibly new feature of nail pigmentation, which were diagnosed during the past 2 years. We also review the clinical and histological findings, differential diagnosis, and treatment of the syndrome in published literature. PMID:23174847